At 0730, the nurse is preparing to give a client with type 1 diabetes the prescribed insulin lispro 6 units subcutaneously with breakfast. The client's capillary blood glucose is 146 mg/dL. The dietary department reports that the breakfast tray will be delayed until 0830. Which action should the nurse take?
- AGive the insulin lispro now so that the dose is given at the scheduled time.
- BHold the insulin until the tray arrives and the client can eat.
- CGive the insulin now and provide a carbohydrate snack until the tray arrives.
- DOmit this dose and document that the client's meal was delayed.
Show answer and explanations
Answer
B
A: Mealtime rapid-acting insulin without available food increases hypoglycemia risk. B: Rapid-acting lispro is timed to the meal, so the dose should be given when food is actually available. C: A snack does not match the meal the lispro dose is meant to cover, so hypoglycemia can still occur before or after the delayed meal; the dose should be timed to the meal. D: Automatic omission does not establish an appropriate revised treatment plan.
A
Mealtime rapid-acting insulin without available food increases hypoglycemia risk.
B
Rapid-acting lispro is timed to the meal, so the dose should be given when food is actually available.
C
A snack does not match the meal the lispro dose is meant to cover, so hypoglycemia can still occur before or after the delayed meal; the dose should be timed to the meal.
D
Automatic omission does not establish an appropriate revised treatment plan.