A nurse is caring for a client who receives insulin lispro each morning at 0730. The nurse should anticipate the client's insulin to peak around which of the following times?

A. "You can use an eyebrow pencil to fill in your eyebrows.": This statement provides practical, supportive guidance that empowers the client to manage visible effects of chemotherapy. Offering concrete strategies for coping with hair loss helps maintain self-esteem and promotes a sense of control during treatment.

B. "I lost my hair, too, when I went through chemotherapy.": Sharing personal experiences can sometimes foster connection, but it may shift focus away from the client’s feelings and minimize their individual emotional response. The priority is validating the client’s concerns rather than centering the nurse’s experiences.

C. "Before you know it, your hair will grow back.": While hair regrowth is expected after chemotherapy, this statement may unintentionally dismiss the client’s current distress. It does not address the emotional impact of hair loss in the present moment.

D. "You should focus on getting better.": This directive can be perceived as dismissive and minimizes the client’s emotional experience. It fails to acknowledge the psychosocial impact of chemotherapy side effects and does not offer supportive guidance.

A. Nitrites negative: Nitrites in the urine are typically produced by certain gram-negative bacteria that convert nitrates to nitrites. A negative nitrite result suggests the absence of common bacterial urinary tract infection pathogens and is considered a normal finding.

B. Ketones positive: Positive urinary ketones indicate fat breakdown and possible metabolic imbalance. In adolescents, this may be associated with uncontrolled diabetes mellitus, prolonged fasting, eating disorders, or dehydration. The presence of ketones raises concern for diabetic ketoacidosis if accompanied by hyperglycemia, making provider notification necessary.

C. Uric acid 475 mg/24 hr: Normal 24-hour urinary uric acid excretion typically ranges from approximately 250 to 750 mg. A value of 475 mg/24 hr falls within expected limits and does not indicate metabolic or renal dysfunction requiring intervention.

D. Specific gravity 1.020: Normal urine specific gravity ranges from about 1.005 to 1.030, reflecting appropriate renal concentrating ability. A value of 1.020 indicates adequate hydration and kidney function, and it does not suggest pathology requiring provider notification.