The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?

A. Incorrect. Withholding insulin during illness is not recommended. Clients with type 1 diabetes should continue to take their prescribed insulin even when they are ill. Insulin is necessary to regulate blood glucose levels, and illness can increase the body's demand for insulin.

B. Incorrect. Drinking calorie-free liquids is important to prevent dehydration during illness, but specific fluid amounts should be individualized based on the client's needs and healthcare provider's recommendations. The given volume is not a universally applicable guideline.

C. Incorrect. Testing blood glucose levels every 8 hours may not be frequent enough during illness. Blood glucose should be monitored more frequently to closely track changes in response to illness and adjust insulin doses accordingly.

D. Correct. Checking urine for ketones when blood glucose levels exceed 240 mg/dL is an important guideline during illness. Elevated blood glucose levels can lead to the production of ketones, and checking for ketones in the urine helps identify the early signs of diabetic ketoacidosis (DKA). If ketones are present, the client should follow a specific plan of action as outlined by their healthcare provider, which may include adjusting insulin doses or seeking medical attention.

Step 1: Convert the Prescribed Dose to Milligrams

The prescribed dose is 0.4 grams (g), but the medication strength is in milligrams (mg). We need to use the same unit for both.

• There are 1000 mg in 1 g.

• To convert 0.4 g to mg, we multiply by 1000.

• 0.4×1000=400

• The prescribed dose is 400 mg.

Step 2: Calculate the Volume (in mL) Needed for the Dose

We know that 5 mL of the syrup contains 100 mg of medication. We need to find out how many mL are needed for 400 mg.

• To find out how many groups of 100 mg are in 400 mg, we divide:

• 400÷100=4

• This means we need 4 times the volume of syrup that contains 100 mg.

• The volume for 100 mg is 5 mL. So, we multiply 4 by 5 mL.

• 4×5mL=20mL

• The total volume needed per dose is 20 mL.

Step 3: Convert the Volume to Teaspoons

The measuring spoon is in teaspoons (tsp). We need to convert 20 mL to teaspoons.

• There are 5 mL in 1 teaspoon.

• To find out how many teaspoons are in 20 mL, we divide 20 by 5.

• 20÷5=4

• The dose is 4 teaspoons.

The nurse will instruct the client to take 4 teaspoons.

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