With what client should the nurse question the administration of human insulin?
A client who has been diagnosed with gestational diabetes.
A client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection.
A client whose type 2 diabetes is controlled by diet and exercise.
A client who has been living with type 1 diabetes for 20 years.
The Correct Answer is C
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
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Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they can take it once a day at the same time.
Choice A. Glulisine is wrong because glulisine is a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Choice C. Aspart is wrong because aspart is another rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
Correct Answer is D
Explanation
Oxygen cannot diffuse rapidly across the membrane to tissues in the eye. This is because diabetic retinopathy is a condition that occurs when high blood sugar levels damage the tiny blood vessels that nourish the retina, the light-sensitive tissue at the back of the eye. As a result, the retina becomes ischemic (lacking oxygen) and tries to grow new blood vessels that are fragile and leaky.
Choice A is wrong because inability of cells in the eye to reproduce is not a cause of diabetic retinopathy.
The retina has a high metabolic rate and needs a constant supply of oxygen and nutrients to function properly.
Choice B is wrong because increase of aqueous humor in the eye is not a cause of diabetic retinopathy.
Aqueous humor is the clear fluid that fills the front part of the eye, not the retina.
An increase of aqueous humor can cause glaucoma, which is a different eye disorder that affects the optic nerve.
Choice C is wrong because decrease of nerve innervations throughout the eye is not a cause of diabetic retinopathy.
Nerve innervations are the connections between nerves and other tissues, such as muscles or glands.
Diabetic retinopathy affects the blood vessels, not the nerves, of the retina.
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