The nurse is administering a dose of NPH insulin at 0800 to an ...

[humphriesbr@me.com]

The nurse is administering a dose of NPH insulin at 0800 to an insulindependent diabetic child. According to when the insulin peaks,the child would be at greatest risk for a hypoglycemic episode between
 
  1. breakfast and lunch.
  2. bedtime and breakfast the nextmorning.
  3. 0830 and a midmorning snack.
  4. lunch and dinner.

Question 2

A child has been admitted to the hospital unconscious.
 
  The child has a history of type 1 diabetes,and according to the child's mother,he took a normal dose of insulin this morning with breakfast. At school the child had two pieces of birthday cake and some ice
  cream at a class birthday party. What is the likely reason for this child's unconscious state?
  1. Metabolic alkalosis
  2. Metabolic ketoacidosis
  3. Insulin shock
  4. Insulin reaction

[dudman123]

Answer to Question 1

Answer:4
Rationale:NPH is intermediate-acting insulin that peaks in six to twelve hours. If administered at 0800,the risk of a hypoglycemic reaction would be between lunch and dinner. A hypoglycemic reaction between breakfast and lunch would be associated with short-acting insulin;between bedtime and breakfast the next morning with long-acting insulin;and between 0830 and a midmorning snack with rapid-acting insulin.

Answer to Question 2

Answer:2
Rationale:Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress.Metabolic alkalosis,insulin shock,or insulin reaction would not be happening in this case.