The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?

Choice A rationale: This statement is incorrect. Insulin can and is administered intravenously in specific clinical situations, particularly for managing diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). Intravenous administration allows for rapid and precise titration of insulin dosage to achieve stable blood glucose levels.
Choice B rationale: Regular insulin is the only type of insulin that can be administered intravenously. Its short duration of action and predictable profile make it ideal for titrating doses in a controlled hospital setting. Other types of insulin, such as rapid-acting or long-acting analogs, are not formulated for intravenous use and carry a risk of unpredictable effects.
Choice C rationale: Insulin aspart and insulin lispro are rapid-acting insulins designed for subcutaneous administration. They are not approved or recommended for intravenous use due to their formulation and the potential for dose-response unpredictability. There is no established protocol for administering these insulins intravenously, even with a dose reduction.
Choice D rationale: While intravenous insulin is often used in emergent situations like DKA or HHS, it is not limited to emergencies. It may also be used in other controlled settings, such as during surgery or in critical care, to manage hyperglycemia. Its use is based on the need for tight glycemic control rather than just emergency status.

Choice A rationale: For a young adult with newly diagnosed type 1 diabetes mellitus, annual eye examinations by an ophthalmologist are recommended starting five years after the diagnosis. The risk of diabetic retinopathy, a microvascular complication, increases over time with chronic hyperglycemia. Therefore, maintaining a regular schedule for eye exams is crucial for early detection and management of vision changes.
Choice B rationale: This statement is incorrect as it suggests waiting for a vision problem to develop or until a later age. Regular, proactive screening is essential for managing diabetes. Diabetic retinopathy often progresses without noticeable symptoms in its early stages, so waiting for a change in vision can lead to delayed treatment and more significant damage.
Choice C rationale: This statement is inaccurate because while vision can be affected, it does not necessarily change quickly in the early stages. The recommendation for annual or even more frequent exams is based on the duration of diabetes and the presence of any complications, not an assumption of rapid change. For a newly diagnosed client, the standard is annual exams after a few years.
Choice D rationale: This statement is dangerously incorrect. Chronic hyperglycemia is a major risk factor for several eye diseases, including diabetic retinopathy, cataracts, and glaucoma. All clients with diabetes, regardless of age or how well-controlled their blood sugar is, are at risk for these complications and require regular, scheduled eye examinations to monitor for early signs of damage.