A nurse on an inpatient endocrine unit has received report on a group of four patients. Which patient should the nurse see first?
A.
Blood glucose of 78 mg/dL, 12-year-old child
B.
Had Humalog injection and is not eating
C.
Needs teaching on giving insulin injections
D.
NPH insulin given, waiting an hour to eat
ANS: B
Humalog is a rapid-acting insulin, and a meal must be eaten within about 15 minutes of the injection, so the nurse needs to assess this patient first. The 12-year-old's blood sugar is normal, and if it gets lower the child is old enough to recognize hypoglycemia and call the nurse. NPH has an onset of action of 2-4 hours, so waiting an hour to eat will not cause a problem. The child who needs teaching will need an extended amount of time, so the nurse ensures all the other patients are stable prior to beginning the teaching session.
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