The nurse instructs a patient with diabetes mellitus about subcutaneous insulin administration. What does the nurse include in patient teaching?
a. Remember that NPH insulin peaks within 15 minutes.
b. Prepare for hyperglycemia 2 hours after taking insulin.
c. Keep insulin refrigerated after adminis-tering the first dose.
d. Eat right after taking regular insulin to avoid hypoglycemia.
D
Regular insulin peaks 15 to 30 minutes after subcutaneous administration; thus the patient needs to eat right after administering the insulin to prevent a hypoglycemic emergency. Once it is ad-ministered, the insulin begins to drive glucose into the cells, resulting in a lower blood sugar; thus, if the patient does not eat to sustain the blood sugar, he or she becomes hypoglycemic. NPH, intermediate-acting insulin, peaks 2 to 6 hours after subcutaneous administration. Because insulin drives glucose into the cells, the blood sugar is more likely to drop than to increase after insulin administration. The nurse teaches the patient to store insulin at room temperature as long as the patient is the only person using the insulin vial.
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