TEST BANK For Understanding the Essentials of Critical Care Nursing, 3rd Edition by Perrin, Verified Chapters 1 - 19, Complete Newest Version

TEST BANK For Understanding the Essentials of
Critical Care Nursing, 3rd Edition by Perrin, Verified
Chapters 1 - 19, Complete Newest Version
AirlshouldlbelinjectedlintolthelNPHlinsulinlvilelfirst,lwhichlallowslwithdrawalloflthelNPHlinsulinl
atlallaterlsteplinlthelprocedurelwithoutlhavingltolinstilllairlintolthelviallfromlalsyringelthatlcontai
nslregularlinsulin.lInstillinglairlintolthelregularlinsulinlvilelincreaseslthelpressurelinlthelvile,lfac
ilitatinglremovalloflthelrequiredldose.lRemovingltheldesiredldoseloflinsulinlwhilelthelneedlelisl
stilllinlthelvilelreduceslthelriskloflcontaminationlbylrepeatedlpunctures,landlmaintainslthelsha
rpnessloflthelneedle.lHavinglthelsyringelcontainlregularlinsulinlfirstlpreventslthelneedltolwith
drawlthelregularlinsulinlintolalsyringelthatlcontainslNPHlinsulinlandlinadvertentlylcontaminati
nglthelregularlinsulinlviallwithlthellonger-
actinglNPHlinsulin;lcontaminatinglregularlinsulinlwithlNPHlinsulinlwilllreducelthelspeedlatlwhi
chlthelregularlinsulinlfunctions,lwhichlinlturnlwillldelayltreatmentloflalhyperglycemiclevent.lFi
nalll-
lAlhealthlcarelproviderlprescribesl36lunitsloflNPHlinsulinl(NovolinlN)landl12lunitsloflregularlin

sulinl(NovolinlR).lThelnurselplansltoladministerltheseldrugslinlonelsyringe.lIdentifylthelstepsli
nlthislprocedurelbyllistinglthelnumberslbyleachlpicturelnextltolthelsteplbelowlinlprioritylorder.l(
Startlwithlthelnumberloflthelpicturelthatlrepresentslthelfirstlsteplandlendlwithlthelnumberlbylth
elpicturelthatlrepresentslthellastlstep.)

3.l
Therelislbetterlcontrolloflbloodlglucosellevelslwithlshort-
actingl(regular)linsulin.lThellevelloflglucoselmustlbelmaintainedlaslcloseltolnormallaslpossibl
e.lTheloccurrenceloflacidosislislgreaterlwhenlthelclientlislreceivinglexogenouslinsulin.lThelstr
essloflsurgerylwilllprecipitatelhyperglycemia,lwhichlislbestlcontrolledlwithlexogenouslinsulinl-
lAlclientlwithltypel2ldiabeteslisladmittedlforlelectivelsurgery.lThelhealthlcarelproviderlprescrib

eslregularlinsulinlevenlthoughlorallantidiabeticslwereladequatelbeforelthelclient'slhospitaliza
tion.lThelnurselconcludeslthatlregularlinsulinlislneededlbecauselthe:

1.lClientlwilllneedlalhigherlserumlglucosellevellwhilelonlbedlrest.
l2.lPossibilityloflacidosislislgreaterlwhenlalclientlislonlorallhypoglycemics.

l3lDosagelcanlbeladjustedltolchanginglneedslduringlrecoverylfromlsurgery.

l4.lStressloflsurgerylmaylprecipitateluncontrollablelperiodsloflhypoglycemia.




C.
NovolinlNlislanlintermediate-
actinglinsulinlthatlpeakslapproximatelyl6ltol8lhourslafterladministration.lItlwasladministeredla
tl7lam,lsolbetweenl1landl3lpmlislwhenlthelnurselshouldlanticipatelthatlalhypoglycemiclreactio
nlwillloccur.lDuringltheleveninglorlnightlislwhenlalreactionlfromlallong-
actinglinsulinlislexpected.lLong-
actinglinsulinlhaslalsmalllpeakl10ltol16lhourslafterladministration.lNoonlislwhenlalreactionlfro
mlalshort-actinglinsulinlislexpected.lShort-
actinglinsulinlpeakslinl2ltol4lhourslafterladministration.lWithinl30lminuteslofladministrationlisl

, whenlalreactionlfromlalrapid-actinglinsulinlislexpected.lRapid-
actinglinsulinlpeaksl30ltol60lminuteslafterladministration.l-lAl13-year-old-
childlwithltypel1ldiabeteslislreceivingl15lunitsloflNovolinlRlinsulinlandl20lunitsloflNovolinlNlins
ulinlatl7lamleachlday.lAtlwhatltimelshouldlthelnurselanticipatelalhypoglycemiclreactionlfromlt
helNovolinlNltoloccur?

1.lBeforelnoon
2lInlthelafternoon
3lWithinl30lminutes
4lDuringlthelevening

1.
Insulinlglarginelislreleasedlcontinuouslylthroughoutlthel24-
hourlperiod;lalbedtimelsnacklwilllpreventlhypoglycemialduringlthelnight.lProvidinglalsnacklw
henlsignsloflhyperglycemialarelpresentlislunsafelbecauselitlintensifieslhyperglycemia;liflhyp
erglycemialislpresent,lthelchildlneedslinsulin.lBecauselinsulinlglarginelislallong-
actinglinsulin,lbedtimelsnackslarelrecommendedltolpreventlalhypoglycemiclepisodelduringlt
helnight.lWhenlhypoglycemialdevelops,lthelchildlwilllbelasleep;lthelsnacklshouldlbeleatenlbe
forelgoingltolbed.l-lAnl8-year-
oldlchildlislbeinglgivenlinsulinlglarginel(Lantus)lbeforelbreakfast.lWhatlislthelmostlappropriat
elinformationlforlthelnurseltolgivelthelparentslconcerninglalbedtimelsnack?

1lOfferlalsnackltolpreventlhypoglycemialduringlthelnight.
2lGivelthelchildlalsnackliflsignsloflhyperglycemialarelpresent.
3lAvoidlalsnacklbecauselthelchildlislbeingltreatedlwithllong-actinglinsulin.
4lKeeplalsnacklatlthelbedsidelinlcaselthelchildlgetslhungrylduringlthelnight.

4.
Exerciselreduceslthelbody'slneedlforlinsulin.lIncreasedlmusclelactivitylacceleratesltransportl
oflglucoselintolmusclelcells,lthuslproducinglanlinsulin-
likeleffect.lWithlincreasedlgrowthlandlassociatedldietarylintake,lthelneedlforlinsulinlincrease
slduringlpuberty.lAnlinfectiouslprocesslmaylrequirelincreasedlinsulin.lEmotionallstresslincre
aseslthelneedlforlinsulin.l-lAlnurselislteachinglal10-year-
oldlchildlwithltypel1ldiabeteslaboutlinsulinlrequirements.lWhenlshouldlthelnurselexplainlthatli
nsulinlneedslwillldecrease?

1lWhenlpubertylislreached
2lWhenlinfectionlislpresent
3lWhenlemotionallstressloccurs
4lWhenlactivelexerciselislperformed

2.
Regularlinsulinlislthelonlylinsulinlthatlisladministeredlintravenously.lNovolinlLlinsulinlcannotlb
eladministeredlintravenously.lNovolinlNlinsulinlcannotlbeladministeredlintravenously.lNovol
inlUlinsulinlcannotlbeladministeredlintravenously.l-
lAlclientlwithltypel1ldiabeteslisldiagnosedlwithldiabeticlketoacidosislandlinitiallyltreatedlwithlin