When caring for a patient in skeletal traction, the nurse should complete which 4 interventions?

Choice A rationale

Insulin lispro (Humalog) is a rapid-acting insulin that begins to lower blood glucose within 15 minutes of injection, with a peak effect occurring in 30 minutes to 1 hour. It mimics the insulin release following a meal, allowing for better postprandial glucose control.

Choice B rationale

Intermediate-acting insulin, such as NPH, has an onset of 1.5 to 4 hours and provides blood glucose control over an extended period. Insulin lispro does not fit this profile, as it acts quickly and is used for meal-time glucose management.

Choice C rationale

Long-acting insulins, such as glargine or detemir, have no peak and provide basal glucose control for 24 hours or more. Lispro is not suitable for basal control due to its rapid action and short duration.

Choice A rationale

Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.

Choice B rationale

Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.

Choice C rationale

Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.

Choice D rationale

Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.