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The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?

A.

1AM while sleeping

B.

PM shortly after lunch

C.

6 PM shortly after dinner

D.

11:00 AM, shortly before lunch

Answer and Explanation

The Correct Answer is A

1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness  about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk  for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical  period for monitoring blood glucose levels.

B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been  about 3 hours since administration, and the insulin is still working to lower blood glucose levels.  This time frame is not associated with the highest risk of hypoglycemia. 

C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH  insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as  it would be later in the night. 

D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the  previous evening have largely worn off. This time frame is not associated with a high risk of  hypoglycemia related to the evening dose of NPH insulin.


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Related Questions

Correct Answer is D

Explanation

A. Incorrect. Palpitations, which are rapid or irregular heartbeats, are more commonly associated with hyperthyroidism, where there is an excess of thyroid hormones.

B. Incorrect. Diaphoresis, or excessive sweating, is not typically associated with hypothyroidism.

C. Incorrect. Exophthalmos, or bulging of the eyes, is a characteristic finding in hyperthyroidism (specifically Graves' disease) and is not typically seen in hypothyroidism.

D. Correct. Weight gain is a common finding in hypothyroidism. The slowing down of metabolic processes due to insufficient thyroid hormones can lead to an increase in body weight.

Correct Answer is D

Explanation

A. NPH insulin: NPH insulin, also known as Neutral Protamine Hagedorn, is an intermediate acting insulin. It has a slower onset of action and a longer duration compared to regular insulin. It is not the best choice for treating diabetic ketoacidosis (DKA) because it does not act quickly enough to lower dangerously high blood glucose levels in this acute situation.

B. Insulin glargine: Insulin glargine is a long-acting basal insulin. It has a slow, steady release and provides a consistent level of insulin over an extended period. Like NPH insulin, it is not suitable for rapidly lowering blood glucose levels in a DKA emergency.

C. Insulin detemir: Insulin detemir is another long-acting basal insulin similar to glargine. It has a slow onset and provides a sustained release of insulin. It is not the first-line choice for treating DKA due to its slower action.

D. Regular Insulin: Regular insulin, also known as short-acting or fast-acting insulin, has a rapid onset of action. When administered intravenously, it can quickly lower blood glucose levels. This makes it the preferred choice for treating diabetic ketoacidosis (DKA) where prompt action is essential to correct the severe hyperglycemia and associated metabolic imbalances.

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