Pharmacology Diabetes meds #10

Question

The nurse is providing instruction to a patient on self-administration of lispro insulin. The nurse will stress which time frames to administer the injection of lispro insulin?

Answers

  1. Inject lispro subcutaneous daily at noon
    • Rationale:

      This answer is not correct because lispro should not be given at a certain time (daily at noon), but administered 15 minutes prior to eating. The patient taking lispro should eat within 15 minutes of receiving lispro, otherwise, there is a risk of hypoglycemia. If the patient cannot eat their meal within 15 minutes of administration, a concentrated carbohydrate should be eaten (6-8 pieces of hard candy, sugary drink, or glucose tablets) to prevent an unsafe low blood glucose level.

  2. Inject lispro subcutaneous nightly prior to bedtime snack.
    • Rationale:

      This answer is not correct because injecting lispro nightly prior to a bedtime snack is not the best answer. Lispro should be administered 15 minutes prior to eating a meal. Most individuals taking lispro prior to meals, take longer acting insulin in between meals and at bedtime.

  3. Inject lispro subcutaneous 30 minutes prior to breakfast.
    • Rationale:

      This answer is not correct because lispro begins to act within 15 minute of injection so giving the insulin 30 minutes prior places the patient at risk for hypoglycemia. Lispro is a fast-acting insulin that starts to work 15 minutes after being given. The insulin peaks in about an hour and continues to work for 2 to 4 hours.

  4. Inject lispro subcutaneous 15 minutes prior to eating.
    • Rationale:

      This answer is correct because lispro is a fast-acting insulin that starts to work 15 minutes after being given. The insulin peaks in about an hour and continues to work for 2 to 4 hours. The patient taking lispro should eat within 15 minutes of receiving lispro, otherwise, there is a risk of hypoglycemia.

Overview

Lispro is a rapid-acting insulin and should be given 15 minutes prior to eating.

Explanation

The client would inject Lispro 15 minutes prior to eating. Lispro (Humalog) insulin is rapid acting insulin and has an onset of less than 15 minutes and peak effect may occur in 30-90 minutes with duration of less than 5 hours. Since its effect is exerted within 15 minutes, patients must eat within this time frame. The selection A and B do not have time elements listed which is critical for this rapid acting drug. Selection C refers to Humulin R, or Novolin R, which are in the regular insulin family and are short acting versus rapid acting. Regular insulins start working within 30 -60 minutes, peak in 2-4 hours, and have duration of 4-8 hours.

Learning Outcomes

Lispro is a fast-acting insulin that starts to work 15 minutes after being given. The insulin peaks in about an hour and continues to work for 2 to 4 hours. The patient taking lispro should eat within 15 minutes of receiving lispro, otherwise, there is a risk of hypoglycemia. If the patient cannot eat their meal within 15 minutes of administration, a concentrated carbohydrate should be eaten (6-8 pieces of hard candy, sugary drink, or glucose tablets) to prevent an unsafe low blood glucose level.

Test Taking Tip

Knowing about onset, peak, and duration of insulins is important because it is a safety issue if the nurse does not know and consider when administering insulins. NCLEX will want you to be a safe nurse so expect to be tested on this important subject.

Video Rationale