A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply)

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

Choice A reason: Tremors are a common sign of hypoglycemia, which occurs when the blood glucose level drops below 70 mg/dL. Hypoglycemia can cause shakiness, nervousness, and anxiety.

Choice B reason: Polydipsia, or excessive thirst, is not a manifestation of hypoglycemia, but rather of hyperglycemia, which occurs when the blood glucose level is too high. Hyperglycemia can cause dehydration, dry mouth, and increased urination.

Choice C reason: Confusion is another common sign of hypoglycemia, which can affect the brain's function and cognition. Hypoglycemia can cause dizziness, headache, difficulty concentrating, and impaired judgment.

Choice D reason: Polyphagia, or excessive hunger, is also not a manifestation of hypoglycemia, but rather of hyperglycemia. Hyperglycemia can cause the body to break down muscle and fat for energy, resulting in weight loss and increased appetite.

Choice E reason: Polyuria, or excessive urination, is also not a manifestation of hypoglycemia, but rather of hyperglycemia. Hyperglycemia can cause the kidneys to excrete excess glucose in the urine, leading to fluid loss and electrolyte imbalance.