7.13. The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, and notifies the health care provider of the incident, and completes an incident report. Wha...
The nurse provides information to a client diagnosed with insulin-dependent diabetes mellitus. Which
manifestations resulting from a blood glucose level less than 70 mg/dL (4 mmol/L) should the nurse
include in the information? Select all that apply.
A. Hunger
B. Sweating
C. Weakness
D. Nervousness
E. Cool clammy skin
F. Increased urinary output
A, B, C, D, E
Hypoglycemia is characterized by a blood glucose level less than 70 mg/dL (4 mmol/L). Clinical
manifestations of hypoglycemia include hunger, sweating, weakness, nervousness, cool clammy skin,
blurred vision or double vision, tachycardia, and palpitations. Increased urinary output is a manifestation
of hyperglycemia.
A client diagnosed with diabetes mellitus receives 8 units of regular insulin subcutaneously at 7:30 am.
The nurse should be most alert to signs of hypoglycemia at what time during the day?
A. 9:30 am to 11:30 am
B. 11:30 am to 1:30 pm
C. 1:30 pm to 3:30 pm
D. 3:30 pm to 5:30 pm
A. 9:30 am to 11:30 am
Regular insulin is a short-acting insulin. Its onset of action occurs in a half hour and peaks in 2 to 4 hours.
Its duration of action is 4 to 6 hours. A hypoglycemic reaction will most likely occur at peak time, which
in this situation is between 9:30 am and 11:30 am.
, The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in
approximately how many hours following administration?
A. 1 hour
B. 2 to 3 hours
C. 8 to 12 hours
D. 16 to 24 hours
C. 8 to 12 hours
other options give either times that are too long or too short
The nurse is teaching a client how to mix regular and NPH insulins in the same syringe. Which action
should the nurse instruct the client to take?
A. Draw up the NPH insulin into the syringe first.
B. Keep both bottles in the refrigerator at all times.
C. Rotate the NPH insulin bottle in the hands before mixing.
D. Take all of the air out of the insulin bottles before mixing
C. Rotate the NPH insulin bottle in the hands before mixing.
the NPH insulin bottle needs to be rotated for at least 1 minute between both hands. This resuspends
the insulin. The nurse should not shake the bottles. Shaking causes foaming and bubbles to form, which
may trap particles of insulin and alter the dosage. Regular insulin is drawn up before NPH insulin. Insulin
may be maintained at room temperature. Additional bottles of insulin for future use should be stored in
the refrigerator. Air does not need to be removed from the insulin bottles
The client's health care provider has prescribed regular insulin 10 units and NPH insulin 20 units
subcutaneously every morning. Which nursing action regarding administration of insulin is correct?
A. Shake the NPH insulin vial to distribute the suspension.
B. Administer each type of insulin using separate syringes.
C. Administer both the regular insulin and the NPH insulin at 12:00 noon
D. Draw up the regular insulin first, and then the NPH insulin in the same syringe.
D. Draw up the regular insulin first, and then the NPH insulin in the same syringe.
Regular insulin and NPH insulin can be mixed together in the same syringe for administration. Regular
insulin is drawn up before the NPH insulin. Insulin is usually administered 15 to 30 minutes before a
meal. To mix the NPH insulin suspension, the vial should be gently rotated. Shaking should be avoided
because doing so introduces air bubbles into the solution.
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