The nurse is to administer insulin to a diabetic client. The finger stick blood glucose is 128.

The client has 4 units of insulin lispro scheduled with meals in addition to the following adjustments scale. How many units of insulin will the nurse administer?

Choice A rationale
It is not advisable for a patient to discontinue radioactive iodine therapy at any time if they feel uncomfortable. Radioactive iodine therapy is a safe and effective treatment for certain types of thyroid cancer. Discontinuing the medication without medical advice could lead to ineffective treatment.
Choice B rationale
Increasing the consumption of iodine-rich foods is not necessary when a patient is prescribed radioactive iodine. The body’s thyroid cells absorb the radioactive iodine, which then destroys the cells. Consuming additional iodine would not enhance this process.
Choice C rationale
Using a straw to drink the medication is not necessary. Radioactive iodine is usually given in pill form, not as a liquid. Therefore, there is no risk of it staining the patient’s teeth.
Choice D rationale
This statement is correct. After a total thyroidectomy, the patient will no longer have thyroid tissue that can produce thyroid hormones. Therefore, the radioactive iodine will not eliminate the need for thyroid hormone replacement.

Choice A rationale
This choice is correct. Calcium carbonate, which is used to treat GERD, can lead to hypercalcemia, or high levels of calcium in the blood, if taken in excess or if the client has impaired kidney function. Hypercalcemia can cause various symptoms, including nausea, vomiting, constipation, and abdominal pain. It can also affect the nervous system, leading to confusion, lethargy, and fatigue. In severe cases, it can cause cardiac arrhythmias.
Choice B rationale
Metabolic alkalosis is a condition characterized by a high level of bicarbonate in the blood, leading to an increase in blood pH. While antacids like calcium carbonate can potentially cause metabolic alkalosis if taken in large amounts, it is less likely to occur in patients taking the medication for GERD, as the medication is used to neutralize stomach acid. Therefore, while it’s a potential risk, it’s less likely than hypercalcemia.
Choice C rationale
Hepatotoxicity, or liver damage, is not typically associated with the use of calcium carbonate. This medication does not have a direct effect on the liver, so it’s unlikely to cause hepatotoxicity unless the client has an underlying liver condition or is taking other medications that can cause liver damage.
Choice D rationale
Hyperphosphatemia, or high levels of phosphate in the blood, is not typically a risk associated with the use of calcium carbonate. In fact, calcium carbonate can bind to phosphate in the gut and reduce phosphate absorption, which can help manage high phosphate levels in certain conditions. Therefore, this choice is not the most likely risk for the client.