Key Concepts
Introduction
Continuous subcutaneous insulin infusion (CSII) via insulin pump delivers rapid-acting insulin analogs to mimic physiologic insulin secretion. The basal rate provides continuous low-dose insulin to suppress hepatic glucose production between meals and overnight, while patient-programmed bolus doses cover carbohydrate intake and correct hyperglycemia. Modern pumps may integrate with continuous glucose monitors (CGM) in sensor-augmented pump therapy or hybrid closed-loop systems. Pump therapy reduces A1C and glycemic variability compared to multiple daily injections (MDI) but carries unique risks: site failure, pump malfunction, and rapid progression to DKA because no long-acting insulin depot exists. The nurse must manage pump therapy during hospitalization, troubleshoot device issues, and implement sick day protocols. On the exam, writers often pair stable-sounding options with unstable dataโnotice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail quietly. When two answers feel partly right, pick the one...