The nurse is administering an 0800 dose of NPH insulin to an insulin-dependent diabetic child. Based on when the insulin peaks, at which period would the child be at greatest risk for a hypoglycemic episode?
1. Between breakfast and lunch
2. Between bedtime and breakfast the next morning
3. Between 0830 and a midmorning snack
4. Between lunch and dinner
4
Rationale:
1. A hypoglycemic reaction between breakfast and lunch would be associated with short-acting insulin.
2. A hypoglycemic reaction between bedtime to breakfast the next morning would be associated with long-acting insulin.
3. A hypoglycemic reaction between 0830 and a midmorning snack would be associated with rapid-acting insulin.
4. NPH is intermediate-acting insulin that peaks in 6–12 hours. If administered at 0800, the risk of a hypoglycemic reaction would be between lunch and dinner.
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