11. ANSWERB. NPH is intermediate acting insulin. The onset of action is 1-2 hours, it peaks in 6-14 hours, and it’s duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
12. ANSWERA. An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day and night, and the client can self-administer a bolus with additional dosage from the pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.
13. ANSWERA. In diabetic acidiosis the arterial pH is less than 7.35. plasma bicarbonate is less than 15mEq/L, and the blood glucose level is higher than 250mg/dl and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmauls respirations would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis.
14. ANSWERD. The most appropriate intervention is to address the client’s feelings related to the anxiety. Administering a sedative is not the most appropriate intervention. The nurse should not ignore the client’s anxious feelings. A client will not relate to medical terms, particularly when anxiety exists.
15. ANSWERA. Increased blood glucose will cause the kidneys to excrete the glucose on the urine. This glucose is accompanied by fluids and electrolytes, causing osmotic diuresis leading to dehydration. This fluid loss must be replaced when it becomes severe. Options B, C, and D are not related specifically to the issue of the question.
16. ANSWERA. lack (absolute or relative) of insulin is the primary cause of DKA. Treatment consists of insulin administration (regular insulin), IV fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis. Applying an electrocardiogram monitor is not a priority action.
17. ANSWERD. An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic hyperosmolar nonketotic syndrome or diabetic ketoacidosis.
18. ANSWERA. A hypoglycemic reaction may occur in the response to increased exercise. Clients should avoid exercise during the peak time of insulin. NPH insulin peaks at 6-14 hours; therefore afternoon exercise will occur during the peak of the medication. Options B, C, and D do not address peak action times.
19. ANSWERA. Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements.
20. ANSWERA. Glucose catabolism is the main pathway for cellular energy production.