The nurse has administered NPH insulin at 1700.
At what time would the nurse anticipate the peak action of this insulin?

Between 2100 and 0500

There is no peak action with neutral protamine hagedorn insulin

Between 1800 and 2100

At 1930

Answer and Explanation

The Correct Answer is A

Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:

Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.

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Correct Answer is A

Explanation

Choice A rationale:

Glucagon directly addresses the underlying issue of severe hypoglycemia: In a patient with Type 1 diabetes mellitus, a blood glucose level of 40 mg/dL signifies a critical condition known as severe hypoglycemia. This condition occurs when blood sugar levels drop dangerously low, depriving the brain and other vital organs of glucose, their primary source of energy. Glucagon, a hormone that acts opposite to insulin, is the most effective and rapid treatment for severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, quickly raising blood sugar levels and restoring normal brain function.

Rationale for other choices:

Choice B: Give orange juice: While orange juice contains carbohydrates that can raise blood sugar, it is not ideal for treating severe hypoglycemia due to its slower absorption rate compared to glucagon. In an unconscious patient, there's also a risk of aspiration if given orally.

Choice C: Perform CPR: CPR is not indicated in this scenario as the patient has a pulse. CPR is a lifesaving technique that is only used when a person's heart has stopped beating.

Choice D: Give insulin: Insulin, which lowers blood glucose, would be contraindicated in this situation as the patient is already experiencing severe hypoglycemia. Administering insulin would further decrease blood sugar levels, worsening the patient's condition.

Key points to remember:

Severe hypoglycemia is a medical emergency that requires prompt treatment with glucagon.

Glucagon is the only medication that can effectively and quickly raise blood glucose levels in severe hypoglycemia. It's crucial to administer glucagon as soon as possible to prevent irreversible brain damage or even death.

Healthcare professionals should be proficient in recognizing the signs and symptoms of severe hypoglycemia and administering glucagon appropriately.

A. Fever. B. Insomnia. C. Bitter or metallic taste. D. Seizures.

Correct Answer is C

Explanation

Choice A rationale:

Fever is not a common side effect of metformin. While it's possible for a minority of patients to experience a mild fever as their bodies adjust to the medication, it's not considered a typical or expected adverse effect.

Fevers typically occur due to infections or inflammation, and metformin does not directly cause either of these processes.

If a patient taking metformin develops a fever, it's crucial to rule out other potential causes, such as infections or other medications, before attributing it to metformin.

Choice B rationale:

Insomnia is also not a common side effect of metformin. In fact, some studies have suggested that metformin may even have a positive effect on sleep quality in some individuals.

While sleep disturbances can occur with any medication, they are not specifically associated with metformin.

If a patient experiences insomnia while taking metformin, it's essential to consider other potential factors, such as stress, anxiety, or other medications, that could be contributing to sleep problems.

Choice C rationale:

Bitter or metallic taste is a very common side effect of metformin, experienced by approximately 30-40% of patients. This taste disturbance is thought to be caused by metformin's interaction with taste receptors on the tongue.

The taste is often described as metallic, bitter, or similar to the taste of pennies.

While it can be unpleasant, it's generally not considered a serious side effect and does not usually require discontinuation of the medication.

Some strategies to manage the metallic taste include: Taking metformin with meals or snacks to mask the taste.

Chewing sugar-free gum or sucking on hard candy after taking the medication. Rinsing the mouth with water or mouthwash after taking the medication.

Switching to an extended-release formulation of metformin, which may have a less pronounced metallic taste.

Choice D rationale:

Seizures are a rare but serious side effect of metformin.

They are most likely to occur in patients with underlying kidney problems or those taking certain other medications that can interact with metformin.

If a patient taking metformin experiences a seizure, it's critical to seek immediate medical attention.

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The nurse has administered NPH insulin at 1700. At what time would the nurse anticipate the peak action of this insulin?

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Naxlex Comprehensive Predictor Exams

A client is brought to the emergency room unconscious, with a pulse, and with a blood glucose of 40. The client is wearing a Medic-Alert bracelet indicating that he has Type 1 diabetes mellitus.What order should the nurse anticipate?

Correct Answer is A

Explanation

A patient is prescribed metformin (Glucophage). Which side effect/adverse effect almost always occurs when clients take metformin (Glucophage)?

Correct Answer is C

Explanation

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The nurse has administered NPH insulin at 1700.
At what time would the nurse anticipate the peak action of this insulin?