A charge nurse is planning an in-service for new graduate nurses on safety considerations related to drug therapy. Which consideration(s) should the charge nurse plan to include in the teaching? Select all that apply.

• Check client's blood glucose level: Assessing blood glucose prior to insulin administration ensures the correct dose is given and prevents hypoglycemia. Pre-administration checks allow safe and individualized dosing based on current glucose levels.

• Identify client using 2 identifiers: Verifying the client’s identity with two identifiers (e.g., name and date of birth) is essential before giving insulin to prevent medication errors and ensure patient safety.

• Assess client at the time of peak effect: Monitoring the client during the insulin’s peak effect helps detect hypoglycemia, the time when the drug’s action is strongest. Post-administration assessment ensures prompt intervention if adverse effects occur.

• Document time and injection site: Recording the time and site of insulin injection after administration provides a reference for subsequent doses and site rotation. Accurate documentation helps prevent complications such as lipodystrophy and ensures continuity of care.

A. "A sign of hypoglycemia is sweating.": Sweating (diaphoresis) is a classic autonomic symptom of hypoglycemia caused by sympathetic nervous system activation. Other early signs include shakiness, palpitations, and anxiety, which alert the client to low blood glucose before neuroglycopenic symptoms develop.

B. "A sign of hypoglycemia is decreased appetite.": While hyperglycemia may affect appetite, decreased appetite is not a reliable indicator of hypoglycemia. Hypoglycemia typically triggers immediate autonomic and neuroglycopenic symptoms rather than a loss of appetite.

C. "A sign of hypoglycemia is insomnia.": Insomnia is not a characteristic symptom of low blood glucose. Sleep disturbances may occur with hyperglycemia or other conditions but do not indicate acute hypoglycemia.

D. "A sign of hypoglycemia is a low heart rate.": Hypoglycemia generally causes tachycardia due to sympathetic activation, not bradycardia. A low heart rate would not serve as a reliable warning sign of hypoglycemia.