A nurse observes a new diabetic client self-administer insulin lispro for the first time, following client teaching. For each client behavior, click to specify whether the behavior demonstrates effective learning or that further teaching is required.
Massages the site after removing the needle.
Injects insulin into abdomen at 45-90 degree angle.
Checks blood glucose immediately prior to injection.
Shakes insulin to mix it uniformly.
Utilizes correct insulin syringe for injection.
Selects site different from previous injection site.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}
• Injects insulin into abdomen at 45-90 degree angle: Proper injection angle ensures the insulin is delivered into subcutaneous tissue, promoting optimal absorption. The abdomen is the preferred site for rapid-acting insulin like lispro. The client demonstrates correct technique, showing effective learning.
• Checks blood glucose immediately prior to injection: Monitoring blood glucose before insulin administration is essential for safe dosing and avoiding hypoglycemia. The client correctly performs this step, indicating understanding of blood glucose monitoring and insulin timing.
• Utilizes correct insulin syringe for injection: Using the correct syringe type ensures accurate measurement of insulin units. The client demonstrates proper selection and use, reflecting adherence to safe injection practices.
• Selects site different from previous injection site: Rotating injection sites prevents lipodystrophy and maintains consistent insulin absorption. The client demonstrates correct site rotation, showing understanding of long-term injection site care.
• Massages the site after removing the needle: Massaging the injection site can alter insulin absorption and may lead to bruising or tissue damage. Clients should be taught to avoid massaging immediately after injection. This indicates the client needs additional instruction.
• Shakes insulin to mix it uniformly: Rapidly shaking insulin can create air bubbles and denature the protein, reducing effectiveness. Insulin should be gently rolled or inverted if mixing is needed. This behavior requires further teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A client with type 2 diabetes with a blood glucose of 142: This blood glucose level is mildly elevated and generally within a range where insulin administration is safe and appropriate for glycemic control. Withholding insulin is not indicated unless hypoglycemia is present.
B. A client with type 1 diabetes with a blood glucose of 570: This is a critically high blood glucose level, indicating hyperglycemia or possible diabetic ketoacidosis. Administering insulin is essential to reduce blood glucose and prevent further complications.
C. A client with type 1 diabetes with a blood glucose of 56: Hypoglycemia is present, defined as a blood glucose below 70 mg/dL. Administering insulin in this situation could worsen hypoglycemia, potentially causing seizures, loss of consciousness, or death, so the dose should be withheld until glucose is corrected.
D. A client with type 1 diabetes with a blood glucose of 165: This blood glucose level is above normal but not acutely dangerous. Administering the prescribed insulin is appropriate to maintain glycemic control and prevent complications associated with hyperglycemia.
Correct Answer is D
Explanation
A. Suicidal ideations: Alpha-glucosidase inhibitors do not affect central neurotransmitter pathways involved in mood regulation. These agents act locally in the intestine and have no known association with psychiatric adverse effects.
B. Angioedema: This reaction involves immunologic or bradykinin-mediated swelling of deep tissues and is typically linked with ACE inhibitors or certain biologics. Alpha-glucosidase inhibitors do not trigger mast-cell–mediated reactions of this type.
C. Hyperglycemia: These drugs delay carbohydrate absorption in the small intestine by inhibiting brush-border enzymes, which reduces postprandial glucose spikes. They do not cause hyperglycemia; if anything, they reduce glucose surges following meals.
D. Gastrointestinal upset: Alpha-glucosidase inhibitors commonly cause flatulence, abdominal cramping, and diarrhea due to fermentation of undigested carbohydrates in the colon. This GI intolerance results from delayed carbohydrate breakdown and is the primary counseling point for clients.
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