The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

I will inject my insulin by pinching up a large area of skin, and then inserting the needle.

I can mix my regular acting insulin and my Lantus in the same syringe.

I can inject my insulin in the same location each time.

I can use a needle/syringe more than once since I am the only one using it.

I will discard my used syringes in a hard container, like an empty plastic milk jug.

Answer and Explanation

Correct Answer : A,B

A. I will inject my insulin by pinching up a large area of skin, and then inserting the needle.
The correct technique for subcutaneous insulin injection involves pinching a small area of skin (creating a skinfold) and inserting the needle at a 90-degree angle. Injecting into a large area might result in inadequate subcutaneous administration.

B. I can mix my regular acting insulin and my Lantus in the same syringe.
Lantus (insulin glargine) is a long-acting insulin that should not be mixed with other insulins. It should be administered separately to maintain its long-acting profile.

C. I can inject my insulin in the same location each time.
This statement is correct. Injecting insulin into the same general area consistently can help with consistent absorption.

D. I can use a needle/syringe more than once since I am the only one using it.
It is not safe to reuse needles or syringes. Single-use needles and syringes should be disposed of properly after each use to prevent infection and other complications.

E. I will discard my used syringes in a hard container, like an empty plastic milk jug.
This statement is correct. Used syringes should be discarded in a puncture-resistant container, and an empty plastic milk jug can serve as a suitable container for disposal.

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Correct Answer is A

Explanation

A. IV administration of 50% dextrose in water:
This is the correct answer. The client is severely hypoglycemic, and IV administration of 50% dextrose in water is the most rapid way to raise the blood glucose level in an emergency situation.

B. IV bolus of 5% dextrose in 0.45% NaCl:
While this solution contains dextrose, it is not as concentrated as 50% dextrose. In an emergency, a more concentrated solution is needed to rapidly correct severe hypoglycemia.

C. Administer 4 oz. clear juice:
Oral intake may be too slow in this critical situation. IV administration is more appropriate for rapidly raising the blood glucose level.

D. Subcutaneous administration of 12 to 15 units of regular insulin:
This would further lower the blood glucose level and is not appropriate for treating severe hypoglycemia.

A. I will report nausea, vomiting, or diarrhea to my primary care provider. B. I should avoid carbohydrates when I'm sick. C. I should stop taking my insulin or oral antidiabetic agents. D. I will test my blood glucose and test urine ketones every 3 to 4 hours. E. I will continue taking my insulin or oral antidiabetic agents as usual.

Correct Answer is ["A","D","E"]

Explanation

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.

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The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

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