The nurse is administering an insulin drip for a patient in DKA (see image below for medication label) who weighs 231 lbs. The order is to start the insulin drip at 0.1 units/kg/hr. Calculate the milliliters per hour the nurse will set the infusion pump. Round to the nearest whole number.

Rationale:

A. Type 2 diabetes is a chronic, lifelong condition. Education cannot cure the disease, but it empowers the client to manage blood glucose, adopt healthy behaviors, and prevent complications. Believing diabetes can “go away” may lead to poor adherence and unrealistic expectations.

B. Medications help control blood glucose but cannot replace self-management behaviors such as monitoring glucose, maintaining a healthy diet, exercising, and understanding hypoglycemia or hyperglycemia. Education is essential for safe and effective diabetes management.

C. This statement reflects accurate understanding. Diabetes education promotes: Glycemic control through lifestyle and medication adherence, prevention of acute complications like hypoglycemia or hyperglycemia, Reduction of long-term complications such as neuropathy, retinopathy, nephropathy, and cardiovascular disease and empowerment and self-efficacy in disease management

D. Education is necessary for all patients with Type 2 diabetes, regardless of treatment modality. Even those managed with diet, exercise, or oral medications need to understand nutrition, glucose monitoring, physical activity, and complication prevention. Limiting education to insulin therapy overlooks critical self-management skills.

Rationale:

A. Insulin is a protein-based hormone. Freezing causes crystal formation and denaturation of protein structure, which destroys the insulin's ability to lower blood glucose. Using frozen insulin can lead to hyperglycemia due to ineffective doses. Therefore, freezing is contraindicated.

B. Freezing insulin, whether opened or unopened, renders it inactive. Proper storage is essential to maintain potency; storing in a freezer is a common error that can result in ineffective therapy and poor glycemic control.

C. Refrigeration (2–8°C / 36–46°F) preserves insulin stability and potency until the expiration date. Most insulin formulations remain effective for the full shelf life when stored this way. Keeping unopened insulin in the fridge also reduces the risk of accidental temperature fluctuations that can degrade the medication.

D. Once insulin is opened, most vials or pens can be kept at room temperature (up to 30°C / 86°F) for a limited period (usually 28 days for many types, longer for some formulations) without loss of efficacy. Room temperature storage: Reduces injection discomfort (cold insulin can cause burning), maintains potency if within manufacturer-specified duration and must still avoid extremes of heat or freezing