The nurse administers the client’s scheduled dose of insulin…

The nurse administers the client’s scheduled dose of insulin lispro (Humalog) as ordered by the healthcare provider at 0800. The meal trays are not delivered at 0800 and are not expected to arrive until 0850.  The client’s blood glucose prior to insulin administration was 90 mg/dL. What will be the nurse’s next action?

An 85-year-old woman presents with new-onset confusion and 3…

An 85-year-old woman presents with new-onset confusion and 3 days of fever. Her past medical history is significant for hypertension, diabetes mellitus and hyperlipidemia. Her medications include lisinopril, hydrochlorothiazide, metformin, atorvastatin and aspirin. The patient is diagnosed with a urinary tract infeciton, and appropriate antibiotic therapy is initiated. She continues to have a fever 4 days after antibiotic therapy. Abdominal/pelvic CT demonstrates an abscess around the left kidney. What is the most common causative organism in the described abscess?

A 48-year-old man is evaluated for a 3-day history of increa…

A 48-year-old man is evaluated for a 3-day history of increasing confusion and lethargy. His wife urged him to seek treatment after having decreased urine output and abdominal pain for the past month. Two months ago, he was hospitalized for pyelonephritis and treated with ceftriaxone.  Medical history includes: Chronic hepatitis C Medications: None taken Vitals include: Temp 98.6*F, pulse 90/min and blood pressure 98/60 Physical exam: Appears pale and irritable. Oriented to person but not to time or place. There is scleral icterus and jaundice. 2+ pitting edema of the lower extremities. The abdomen is distended with a positive fluid wave. Laboratory studies:   Urinalysis shows no abnormalities. Fractional excretion of sodium (FENa) is < 1% Ultrasound of the kidneys is unremarkable. Intravenous fluids are administered for 36 hours but do not improve urine output. Which of the following is the most likely cause of kidney dysfunction in this patient?