Nursing Diabetes Management Worksheet

A client presents with confusion, sweating, and irritability. Blood glucose is 52 mg/dL. Which additional finding confirms hypoglycemia rather than hyperglycemia?

• Polyuria

• Kussmaul respirations

• Palpitations

• Fruity odor to the breath

A client with type 1 diabetes is found diaphoretic, tremulous, and complaining of palpitations. The nurse checks a blood glucose of 48 mg/dL. Which intervention should the nurse perform first?

• Recheck blood glucose in 15 minutes

• Administer IV dextrose if IV access is available

• Provide orange juice and crackers if the client is awake and alert

• Notify the provider of the blood glucose result

The provider prescribes: • Regular insulin 10 units SQ before breakfast • NPH insulin 20 units SQ before breakfast Which nursing action is most appropriate when preparing the insulin?

• Draw up NPH insulin first, then regular insulin in the same syringe

• Draw up regular insulin first, then NPH insulin in the same syringe

• Administer NPH and regular insulin in two separate syringes

• Mix both insulins together without considering order

The nurse is preparing to give insulin glargine and regular insulin. Which action indicates correct practice?

• Administer glargine and regular insulin in the same syringe to reduce injections

• Administer glargine once daily at the same time, in a separate syringe

• Hold glargine if the client’s blood glucose is less than 120 mg/dL

• Shake the glargine vial before drawing it up

Which client situation requires immediate emergency intervention?

• Blood glucose 400 mg/dL with dry mucous membranes

• Blood glucose 40 mg/dL with slurred speech

• Blood glucose 200 mg/dL with polyuria

• Blood glucose 280 mg/dL with blurred vision

A client with type 1 diabetes is prescribed lispro insulin 10 units subcutaneously before meals. The nurse observes the client’s breakfast tray has not yet arrived. Which action should the nurse take?

• Administer lispro insulin as prescribed

• Hold the insulin until the meal is present and ready to eat

• Call the provider to change to NPH insulin

• Give the insulin and encourage the client to snack until meal arrives

A client with type 1 diabetes is experiencing nausea and vomiting from influenza. Blood glucose is 310 mg/dL. Which action should the nurse reinforce as most important?

• Hold insulin until eating resumes

• Increase fluid intake and monitor glucose

• Avoid insulin until symptoms improve

• Double the insulin dose due to stress

A nurse receives report on four clients. Which client should the nurse see first?

• Client with BG 420 mg/dL, Kussmaul respirations, and dry skin

• Client with BG 48 mg/dL, drowsiness, and difficulty arousing

• Client with BG 250 mg/dL, complaining of thirst

• Client with BG 60 mg/dL, mild tremors, and alert

If a client’s blood glucose is 225 mg/dL, how many units of regular insulin should the nurse administer?

• BG 150–199 → 2 units regular insulin

• BG 200–249 → 4 units

• BG 250–299 → 6 units

• BG 300–349 → 8 units

• 4 units

• 2 units

• 6 units

• 8 units

The nurse is teaching a client about insulin storage. Which statement indicates correct understanding?

• I will keep unopened insulin vials in the refrigerator.

• I will freeze my insulin to extend its shelf life.

• I will store all opened insulin in the refrigerator.

• Once opened, I can use the vial for up to a year.