The patient's meal has been delivered, the nurse checks the patient's pre-meal blood sugar, and the result is 243 mg/dL. The patient is awake, alert, hungry, and able to swallow.
The next step the nurse should take is:

Choice A rationale

Low urine output could be due to dehydration, medication effects, or stress. While it warrants further assessment, it is not typically associated with immediate life-threatening complications in the context of PUD.

Choice B rationale

Vomiting after a meal can occur in PUD due to delayed gastric emptying or irritation. However, it does not immediately indicate a complication requiring urgent follow-up unless accompanied by other symptoms such as severe pain or hematemesis.

Choice C rationale

Blood in the stool may indicate gastrointestinal bleeding, a serious complication of PUD. This finding requires immediate evaluation to determine the source and extent of bleeding, as it can lead to hypovolemic shock if untreated.

Choice D rationale

Abdominal discomfort is common in PUD due to gastric irritation or acid-related issues. While it requires management, it does not typically signal an urgent complication unless associated with other alarming symptoms.

Choice A rationale

Mixing insulin glargine and lispro in the same syringe is contraindicated due to their incompatible chemical formulations. Glargine’s acidic pH alters lispro’s effectiveness when mixed, impairing glycemic control. Separate administration preserves their individual pharmacokinetics and therapeutic actions.

Choice B rationale

Separate injections ensure each insulin maintains its unique action profile. Glargine provides basal control, while lispro manages rapid postprandial spikes. Their chemical incompatibility mandates separate administration, optimizing glycemic management and reducing potential adverse effects from mixed formulations.