Nursing Application: Insulins

A patient with Type 2 diabetes is started on the medication glyburide. Which of the following statements by the patient causes concern? A. "This medication works by stimulating the beta cells in the pancreas to make insulin" B. "I will consume no more than 8oz of alcohol per week" C. "I will monitor my blood glucose regularly because I know this medication can cause a low blood sugar" D. "I will continue monitoring my diet and participating in exercise while taking this medication"

B Glyburide is a sulfonylureas diabetic medication and a patient should NEVER consume alcohol while taking this medication because it can cause severe hypoglycemia.

A patient newly diagnosed with diabetes is about to be discharged home. You are watching the patient administer insulin. Which of the following actions causes you to re-educate them? A. They injected into the fat of their thighs B. they massaged the site after administering the insulin C. They engaged the safety after administering the medication D. They used an opposite site for injection compared to the last insulin injection

B The site should not be rubbed after administration—risk of damaging the underlying tissue and can cause the medication to be absorbed faster than intended.

A patient's blood glucose level is 215 mg/dL. The patient is about to eat lunch. Per sliding scale, you administer 4 units of insulin lispro subcutaneously at 1130. As the nurse, you know the patient is most at risk for hypoglycemia at what time? A. 1230 B. 1145 C. 1430 D. 1630

A If the insulin lispro is given at 1130, the patient is at most risk for hypoglycemia 1 hour after administration, which is 1230.

Which of the following are essential considerations when insulin is being administered? Select all that apply. A. Duration B. Onset C. Termination D. Peak

A, B, D The onset, peak, and duration of an insulin type are essential time/action components to consider when insulin is being administered. The time/action profile table can assist in determining which type of insulin to administer. Termination is not something that is assessed for when taking insulin.

During the initial assessment, which questions should the nurse ask the patient? Select all that apply. A. Were you able to provide a urine sample upon arrival B. How often do you exercise C. Do you lift weights or do cardio exercises D. Do you take any additional medication or supplements

ALL

A client taking insulin glargine asks when the best time is to take this medication. What is the best response by the nurse? A. 1 hour before eating B. Between breakfast and lunch C. at the same time every day D. With the first bite of food

C

Which of the following is not an essential consideration when insulin is being administered? A. duration B. Peak C. Termination D. onset

C

The client has an order for insulin lispro at 07:30. In which circumstances should the nurse delay administering the medication? Select all that apply. C. The client is not allowed to eat or drink until after a procedure D. The client can have the meal tray delivered at their convenience E. The meal tray will arrive 2 hours post insulin admin

C, D, E Insulin lispro begins to exert its effects within 15 minutes of subcutaneous administration, and peak levels occur 30 to 90 minutes after administration. So administering the shot 2 hours before a meal arrives puts the client at high risk for hypoglycemia. A client who is NPO should not be given insulin lispro due to the risk of hypoglycemia. If the client is able to request a meal tray at their convenience, the nurse should remind the client to request their insulin when their meal tray arrives.

The nurse is administering lispro insulin to a client at 0730. Based on the onset of the insulin, the nurse should confirm the following prior to administration? ​ A. the client can have the meal tray delivered at their convenience B. The meal tray will arrive 30min after admin C. The meal tray will arrive 60min after admin D. The meal tray is present at the time of admin

D

A patient is scheduled to take a morning dose of metformin. The patient is scheduled for surgery tomorrow. Which of the following nursing interventions is correct? A. Check the patient's blood glucose prior to administering the medication B. Administer the med as ordered byt hold the next day's dose C. Administer the med as ordered D. Hold the dose and notify the doctor for further orders

D The medication may interfere with anesthesia and surgery/cause risk. The physician needs to be made aware of current medications.

A 38-year-old client has been diagnosed with type 2 diabetes and must take injectable insulin to manage the disease. The nurse is teaching the client about how to inject insulin and the client becomes very upset and anxious at the thought of giving herself an injection. Which response from the nurse is most appropriate?

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