Select words from the choices below to fill in each blank in the following sentence.

To further evaluate the client, the nurse anticipates the client will need

____

and

____

.

A) "Draw up the insulin lispro and insulin glargine in separate syringes.":
Insulin lispro (a rapid-acting insulin) and insulin glargine (a long-acting insulin) should be administered separately, as they have different properties and mechanisms of action. Mixing them in one syringe can affect their effectiveness and may cause inaccurate dosing. Therefore, the nurse should instruct the client to draw up each insulin in a separate syringe to ensure proper administration and action of both insulins.

B) "Take an extra dose of insulin lispro prior to aerobic exercise.":
Taking an extra dose of insulin lispro before exercise is not recommended unless directed by a healthcare provider. Exercise can lower blood glucose levels, and additional insulin may increase the risk of hypoglycemia. Instead, clients with diabetes are typically advised to monitor their blood glucose levels before and after exercise and adjust their insulin dose or carbohydrate intake accordingly, under the guidance of their healthcare provider.

C) "Expect insulin glargine to be cloudy.":
Insulin glargine is a clear, long-acting insulin. It should not be cloudy. If the insulin appears cloudy, it may be a sign that the insulin has been improperly stored or is no longer effective. The nurse should educate the client to inspect the insulin for cloudiness or particles and to discard any insulin that appears abnormal.

D) "Anticipate that the insulin glargine will peak in 3 hours.":
Insulin glargine is a long-acting insulin that does not have a pronounced peak. It provides a steady release of insulin over 24 hours and helps to maintain baseline insulin levels. It is not meant to peak like rapid-acting or short-acting insulins. Therefore, this instruction is incorrect, as insulin glargine does not follow the same peak-action pattern as other insulins.

A) Nausea:
Epinephrine is not typically used to treat nausea. Nausea is usually addressed with antiemetic medications. Epinephrine, an adrenergic agonist, works by stimulating the sympathetic nervous system to alleviate symptoms related to anaphylaxis, such as difficulty breathing or hypotension, but not nausea.

B) Hyperglycemia:
While epinephrine can increase blood sugar levels by stimulating the release of glucose from the liver, it is not used to treat hyperglycemia. Hyperglycemia management typically involves insulin or other medications designed to lower blood sugar, not epinephrine. Therefore, it is not an appropriate indication for this medication.

C) Hand tremors:
Hand tremors are a possible side effect of epinephrine due to its stimulatory effects on the sympathetic nervous system. However, tremors are not an indication for administering epinephrine. The purpose of an epinephrine auto-injector is not to treat tremors but rather to manage more serious conditions, like anaphylactic reactions.

D) Shortness of breath:
Epinephrine is commonly used in emergencies, such as anaphylactic reactions, to alleviate shortness of breath, which occurs due to bronchoconstriction. Epinephrine works by stimulating alpha and beta receptors, causing bronchodilation and improving airflow. This makes it effective in treating shortness of breath caused by allergic reactions or anaphylaxis.