An adolescent is admitted to the intensive care unit with diabetic ketoacidosis. The nurse prepares a continuous insulin infusion of 100 units (U) regular insulin in 500 mL normal saline. How many units of regular insulin is in one mL of the solution?
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- Mr. Morgan was admitted with a diagnosis of diabetic ketoacidosis yesterday. His initial blood glucose reading was 740 mg/dl. An infusion of regular insulin was started for glucose management as well as normal saline infusion for hydration. His latest blood glucose reading is 230 mg/dl as the nurse the next step is toInsulin lispro was given to a client at 0700 by a night nurse who needed to leave early. At 0730 the client is clammy and refusingb reakfast, stating "I don't feel well, I need to lie down," What is the nurse's action? 1) Check the blood sugar and convince the client to drink juice if possible. 2) Document the refusal and let the client sleep since. 3) Call the night nurse at home and tell her to come back and deal with the situation. 4) Wait to offer breakfast until the client feels better.When checking a patient’s fingerstick blood glucose level, the nurse obtains a reading of 42 mg/dL. The patient is awake but states he feels a bit “cloudy-headed.” After double-checking the patient’s glucose level and getting the same reading, which action by the nurse is most appropriate? a) Administer two packets of table sugar.b )Administer oral glucose in the form of a semisolid gel.c) Administer 50% dextrose IV push.d )Administer the morning dose of lispro insulin
- According to the assigned clinical case, determine the maintenance plan and rehydration fluids (if necessary and a Rehydration Calculation is invented). Additionally, indicate the recommended analgesia plan to mitigate the patient's pain. It is important to show the steps to follow to calculate doses and liquids. *In veterinary medicine the maintenance calculation in cats is 60 ml/kg/day or (weight in kg) 0.75x80A 76-year-old patient states, “I have been experiencing com-plications of diabetes.” The nurse needs to direct the patient to gain more information. What is the most appropriate com-ment or question to elicit additional information? a. “Do you take two injections of insulin to decrease thecomplications?” b. “Most physicians recommend diet and exercise to regulateblood sugar.”c. “Most complications of diabetes are related to neuropathy.”d. “What specific complications have you experienced?”A 56-year old maintenance worker, with a past medical history of insulin dependent diabetes, CHF, and hypertension, presents to the emergency room with lightheadedness, lethargy, and periods of confusion. Patient family members found him unconscious outside. Wife states, “he’s been at it for over a weeknow” Medications: Insulin, Lasix, Digoxin and Vasotec: were:Temperature Pulse Respirations36.7C 118 18On examination, the patient has slurred speech with decreased upper and lower motor strength bilaterally 4/5. While examining the patient, he experienced loss of consciousness that lasted less than half a minute. The nurse, drew labs, administered oxygen via NC, Established IV line access and placed patient on a monitor. Lab resultsVitals on admission Blood Pressure 103/61 Electrolytes – in emergency room Hematocrit –PotassiumSodiumPhosphorus 2.6 mg/dL BicarbonateCalciumCreatinineSerum Osmolarity Glucose38%3.3 mEQ/L147 mEQ/L21 mEq/L 7.6 mg/dL2.4 mg/dL321 mmol/kg 389 mg/dL…
- A 12-year-old boy is brought to the physician because of increased urination and progressive fatigue during the past two weeks. Vital signs are within normal limits except for a pulse of 120/min. Physical examination shows dry skin and mucous membranes. His fasting serum glucose concentration is 350 mg/dL. The patient improves after insulin treatment. Which of the following best describes the effect of insulin binding to the insulin receptor (IR) on the surface of hepatocytes in this patient? a. Activation of serine/threonine kinase activity of the IR b. Down regulation of phosphoenolpyruvate carboxykinase c. Inactivation of ras d. Inhibition of glucose-transporter-4 (GLUT-4) translocation to the cell membrane e. Inhibition of phosphatidylinositol-3-kinase signaling pathwayA 68-year-old diabetic male resident in a long term care facility is bedridden and has refused food and fluids for two days. He has a Stage 3 pressure ulcer in the coccyx and multiple venous ulceration in the left lower leg. The following questions will assist the nursing student in the assessment of a client with a skin breakdown. How will you assess for edema of the lower extremities? Describe the key features in pressure ulcer assessment. Describe a Stage III pressure ulcer. Differentiate an arterial ulcer from a venous ulcer.A 68-year-old diabetic male resident in a long term care facility is bedridden and has refused food and fluids for two days. He has a Stage 3 pressure ulcer in the coccyx and multiple venous ulcerations in the left lower leg. The following questions will assist the nursing student in the assessment of a client with a skin breakdown. How will you assess for edema of the lower extremities? Describe the key features in pressure ulcer assessment. Describe a Stage III pressure ulcer. Differentiate an arterial ulcer from a venous ulcer.
- A 56-year old maintenance worker, with a past medical history of insulin-dependent diabetes, CHF, and hypertension, presents to the emergency room with lightheadedness, lethargy, and periods of confusion. Patient family members found him unconscious outside. Wife states, “he’s been at it for over a week now” Medications: Insulin, Lasix, Digoxin, and Vasotec: Vitals on admission were as follows : Temperature/ Pulse/ Respirations /Blood Pressure36.7C 118 18 103/61On examination, the patient has slurred speech with decreased upper and lowermotor strength bilaterally 4/5. While examining the patient, he experienced lossof consciousness that lasted less than half a minute. The nurse drew labs,administered oxygen via NC, Established IV line access and placed the patient on a monitor. Lab resultsElectrolytes – in emergency roomHematocrit – 38%Hemoglobin 12 gm/dLPotassium 3.3 mEQ/LChloride 95 mEq/LSodium 147 mEQ/LPhosphorus 2.6 mg/dLBicarbonate 21 mEq/LCalcium 7.6 mg/dLBUN 46 mg/dLCreatinine…Which of the following are priorities in the acute management of DKA and HHNKS? Question 74 options: a) Long-acting IV insulin to correct glucose over a longer period of time and to prevent cerebral edema, neurovitals every hour to monitor neurological status b) Fluid rehydration, correction of hyperglycemia, monitoring and correcting electrolytes c) Mannitol or 3% saline to prevent cerebral edema as part of fluid rehydration, sodium bicarbonate for metabolic acidosis, correction of hypokalemia d) Gradual fluid rehydration, aggressive correction of hyperglycemia, and correcting sodium levelsA 32-year-old male with type 1 diabetes since the age of 14 years was taken to the emergency department because of drowsiness, fever, cough, diffuse abdominal pain, and vomiting. Fever and cough started 2 days ago and the patient could not eat or drink water. He has been treated with an intensive insulin regimen (insulin glargine 24 IU at bedtime and a rapid-acting insulin analog before each meal). On examination he was tachypneic, his temperature was 39° C (102.2° F), pulse rate 104 beats per minute, respiratory rate 24 breaths per minute, blood pressure 100/70 mmHg; he also had dry mucous membranes, poor skin turgor, and rales in the right lower chest. He was slightly confused. Rapid hematology and biochemical tests showed hematocrit 48%, hemoglobin 14.3 g/dl (143 g/L), white blood cell count 18,000/ μ l, glucose 450 mg/dl (25.0 mmol/L), urea 60 mg/dl (10.2 mmol/L), creatinine 1.4 mg/dl (123.7 μ mol/L), Na+ 152 mEq/L, K+ 5.3 mEq/L, PO4 3−2.3 mEq/L (0.74 mmol/L), and Cl− 110 mmol/L.…