When a client's glucose level drops below 70 mg/dL, often before meals or when insulin action is peaking, the client is experiencing what condition?

Choice A rationale: The abdomen is actually the preferred site for insulin injections due to its consistent and rapid absorption rate compared to other sites. While absorption can vary slightly depending on the specific location within the abdomen, it is considered more predictable than other areas. Avoiding the abdomen would eliminate a prime injection site, which would make proper site rotation more difficult to achieve.
Choice B rationale: Choosing a different site at random for each injection is not the recommended approach. While it ensures rotation, it can make it difficult to monitor for site reactions or track the effectiveness of different injection sites. A systematic rotation strategy is preferred to ensure that all areas are used appropriately and consistently over time, preventing tissue damage.
Choice C rationale: Giving the injection in the same area each time, or even in the same exact spot, is the primary cause of lipohypertrophy and lipoatrophy. Repeated trauma to the same tissue leads to fibrous tissue formation and fat deposition or breakdown, which can significantly alter insulin absorption, making glycemic control unpredictable and increasing the risk of both hypoglycemia and hyperglycemia.
Choice D rationale: Rotating sites within the same anatomical location, such as the abdomen, for approximately one week before moving to a new location (e.g., the thigh or arm), is the recommended practice. This systematic approach ensures that tissue at the injection sites has time to heal, preventing the development of lipodystrophies. It also helps maintain consistent insulin absorption.

Choice A rationale: The Dawn phenomenon is a morning hyperglycemia that results from the normal circadian release of growth hormone and cortisol. These hormones increase glucose production in the liver, leading to elevated blood glucose levels. Unlike the Somogyi phenomenon, it is not preceded by a nocturnal hypoglycemic episode.
Choice B rationale: Insulin resistance is a physiological condition in which cells fail to respond to the normal actions of insulin. The body's cells do not effectively absorb glucose, leading to elevated blood glucose levels. It is a chronic condition and does not involve an acute nocturnal hypoglycemic event followed by a rebound hyperglycemia.
Choice C rationale: Lipodystrophy is a complication of insulin therapy characterized by changes in subcutaneous fat tissue at injection sites. It can present as either lipoatrophy (denting of the skin) or lipohypertrophy (thickening of the skin). This is a localized skin condition and not a systemic metabolic phenomenon related to blood glucose fluctuations.
Choice D rationale: The Somogyi phenomenon is a rebound hyperglycemia that occurs after an episode of undetected hypoglycemia, typically overnight. The low glucose triggers the release of counter-regulatory hormones (glucagon, epinephrine, cortisol, and growth hormone) which stimulate the liver to release glucose, leading to an elevated morning blood glucose level.