A client with type 1 diabetes uses insulin lispro before meals and NPH insulin in the morning. The client is preparing to eat lunch and asks the nurse to review injection technique and storage. Which actions should the nurse recommend? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
The nurse should recommend rotating injections within one anatomic region while avoiding lipohypertrophic tissue (Choice 1), drawing up lispro before NPH when the products are compatible and administering the mixture promptly (Choice 3), and following product-specific storage limits while discarding insulin exposed to extreme temperatures (Choice 5). Lispro should not be given merely when a tray is ordered because an uncertain meal delay can cause hypoglycemia (Choice 2). Insulin must be protected from direct contact with frozen gel packs during travel (Choice 4). The injection site should not be massaged to speed absorption (Choice 6).
Clinical Reasoning The nurse should recommend rotating injections within one anatomic region while avoiding lipohypertrophic tissue (Choice 1), drawing up lispro before NPH when the products are compatible and administering the mixture promptly (Choice 3), and following product-specific storage limits while discarding insulin exposed to extreme temperatures (Choice 5). Lispro should not be given merely when a tray is ordered because an uncertain meal delay can cause hypoglycemia (Choice 2). Insulin must be protected from direct contact with frozen gel packs during travel (Choice 4). The injection site should not be massaged to speed absorption (Choice 6).
Option Review
Correct — Rotating sites within the same region and avoiding lipohypertrophic areas maintains consistent insulin absorption and prevents tissue damage.
Incorrect — Lispro should be given only when the meal is immediately available, generally within 15 minutes before eating or immediately after; tray delivery can be delayed after an order is placed.
Correct — When mixing lispro and NPH, lispro is drawn first to prevent contamination of the rapid-acting insulin with NPH, and the mixture is injected promptly to maintain stability.
Incorrect — Insulin may be carried in an insulated container, but direct contact with a frozen gel pack can freeze and damage it. A barrier should prevent freezing, and any frozen insulin must be discarded.
Correct — Checking storage guidelines and discarding insulin exposed to extreme temperatures ensures medication potency and patient safety.
Incorrect — Massaging an insulin injection site can make absorption less predictable and should not be used to accelerate the effect of lispro.
Sources
12026 NCLEX-RN Test Plan
2DailyMed: Insulin lispro
A client with type 1 diabetes is preparing to eat lunch in a hospital room. The client uses insulin lispro before meals and NPH insulin in the morning. The nurse is reviewing the client's injection technique and storage practices.