Insulin Therapy & Administration Flashcards
7 cards from real Diabetes practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Insulin Therapy & Administration flashcards as text
A nurse educator is teaching a patient about insulin-to-carbohydrate ratios (ICR). A patient's ICR is 1:15. How many units of rapid-acting insulin should be given for a meal containing 60 grams of carbohydrates?
Answer: 4 units
Dividing 60 grams of carbohydrate by the ratio of 15 yields 4 units of rapid-acting insulin for that meal.
Which of the following is a known risk when U-500 regular insulin is confused with U-100 regular insulin?
Answer: A fivefold overdose potentially causing severe hypoglycemia
U-500 is five times more concentrated than U-100; using a standard U-100 syringe to draw U-500 will deliver five times the intended dose, causing life-threatening hypoglycemia.
What is the primary mechanism explaining the dawn phenomenon in people with diabetes?
Answer: Overnight counter-regulatory hormone surges raising hepatic glucose output in the early morning
Growth hormone and cortisol surge in the early morning hours, increasing hepatic glucose production and causing pre-breakfast hyperglycemia in the dawn phenomenon.
Which needle length is generally recommended for most adults administering subcutaneous insulin injections without lifting a skin fold?
Answer: 4 mm
A 4 mm pen needle is short enough to reach subcutaneous tissue without penetrating muscle in most adults when injected perpendicularly.
A patient on basal-bolus therapy reports frequent mid-afternoon hypoglycemia (around 3 PM). The lunch bolus insulin is rapid-acting. What is the most likely cause?
Answer: Lunch bolus dose is too high relative to the carbohydrates consumed
Hypoglycemia occurring 2–4 hours after a meal is most consistent with a lunch bolus that exceeds the carbohydrate intake, leading to excess insulin activity in the afternoon.
Which of the following insulins should NEVER be mixed with any other insulin in the same syringe?
Answer: Insulin glargine (Lantus)
Insulin glargine has a low pH that is incompatible with other insulins and will alter the pharmacokinetics of both insulins if mixed.
A patient with an eGFR of 20 mL/min/1.73m² needs insulin dose counseling. What physiological change should the diabetes educator explain affects insulin requirements?
Answer: Reduced renal insulin degradation, increasing insulin half-life and hypoglycemia risk
The kidneys degrade a significant portion of circulating insulin; in advanced CKD, reduced degradation prolongs insulin action and dramatically increases hypoglycemia risk.