What is the most frequently observed side effect of insulin administration?

Choice A rationale:

Stevens-Johnson syndrome (SJS) is a rare, serious skin condition that is typically caused by an allergic reaction to medication. While amiodarone has been associated with a few cases of SJS, it is not considered a common long-term side effect.

Choice B rationale:

Ventricular tachycardia (VT) is a type of fast heart rhythm that originates in the ventricles of the heart. Amiodarone is actually used to treat VT, so it would be counterintuitive to list it as a long-term side effect.

Choice C rationale:

Pulmonary fibrosis is a condition characterized by scarring of the lung tissue. While amiodarone can cause pulmonary toxicity, which includes pulmonary fibrosis, this is a relatively rare side effect. Moreover, it's usually associated with high doses or

long-term use of the medication.

Choice D rationale:

QT prolongation is a condition in which the heart's electrical activity takes longer than normal to recharge between beats. This can lead to a potentially fatal arrhythmia called torsades de pointes. Amiodarone is known to prolong the QT interval, and this is considered one of its most significant long-term side effects. It's important to monitor patients on amiodarone for QT prolongation and to adjust the dose or discontinue the medication if necessary.

Choice A rationale:

Hypoglycemia is a critical consideration: The patient's symptoms of lethargy, diaphoresis, and combativeness, along with recent insulin administration, raise a strong suspicion of hypoglycemia (low blood sugar). Hypoglycemia can quickly progress to coma and seizures if not promptly treated, making it a high priority to assess and address.

Bedside glucose testing is rapid and reliable: A bedside finger stick blood glucose test is a quick, non-invasive, and accurate way to determine the patient's blood sugar level. It provides immediate results, allowing for prompt intervention if hypoglycemia is confirmed.

Other assessments and interventions can follow: Once hypoglycemia is ruled out or confirmed, the nurse can proceed with other assessments and interventions as needed.

Choice B rationale:

Insulin administration without blood sugar confirmation is dangerous: Administering insulin without first checking the patient's blood sugar could worsen hypoglycemia if it is already present. This could lead to severe complications, including neurological damage or even death.

Insulin timing is not a priority: While the next dose of insulin may be due, its administration is not the most urgent priority in this situation. Addressing the patient's immediate symptoms and potential hypoglycemia takes precedence.

Choice C rationale:

Naloxone is not indicated for hypoglycemia: Naloxone is an opioid antagonist used to reverse opioid overdose. It has no effect on hypoglycemia and would not be appropriate in this case.

Choice D rationale:

Oxygen therapy may not address the underlying issue: While oxygen therapy can be beneficial for patients with respiratory distress, it does not address the potential hypoglycemia in this case. If the patient's lethargy and combativeness are due to low blood sugar, oxygen therapy alone would not be sufficient treatment.

Oxygen saturation is already within normal limits: The patient's oxygen saturation (SPO2) is 97%, indicating that their oxygenation is currently adequate. Oxygen therapy would not be indicated unless there were signs of hypoxia.