A nurse is caring for a client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor breath. Diabetic ketoacidosis (DKA) is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

Choice A reason: Intravenous insulin glargine is inappropriate for DKA, as it is a long-acting insulin designed for subcutaneous use, not rapid correction of acute hyperglycemia and acidosis. Its slow onset cannot address DKA’s urgent need for immediate ketone suppression and glucose reduction. Choice B reason: Intravenous insulin detemir, another long-acting insulin, is not used for DKA treatment. Its prolonged action and subcutaneous design do not provide the rapid onset needed to reverse acidosis and hyperglycemia, making it unsuitable compared to short-acting intravenous regular insulin. Choice C reason: Intravenous NPH insulin is not appropriate for DKA, as it is an intermediate-acting insulin with delayed onset, typically used subcutaneously. DKA requires rapid-acting insulin to quickly suppress ketogenesis and lower glucose, making NPH ineffective for acute management. Choice D reason: Intravenous regular insulin is the standard treatment for DKA, as its rapid onset (minutes) allows quick suppression of ketogenesis and hyperglycemia. Delivered via infusion, it corrects acidosis by inhibiting lipolysis and gluconeogenesis, making it the most effective choice for acute DKA management.