Health Promotion and Maintenance Q 92
Rico with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U-100 regular insulin and 35 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
A. “Inject insulin into healthy tissue with large blood vessels and nerves.”
B. “Rotate injection sites within the same anatomic region, not among different regions.”
C. “Administer insulin into areas of scar tissue or hypertrophy whenever possible.”
D. “Administer insulin into sites above muscles that you plan to exercise heavily later that day.”
Correct Answer: B. “Rotate injection sites within the same anatomic region, not among different regions.”
The nurse should instruct the client to rotate injection sites within the same anatomic region. Rotating sites among different regions may cause excessive day-to-day variations in the blood glucose level; also, insulin absorption differs from one region to the next.
Option A: Insulin should be injected only into healthy tissue lacking large blood vessels, nerves, or scar tissue, or other deviations.
Option C: Injecting insulin into areas of hypertrophy may delay absorption. The client shouldn’t inject insulin into areas of lipodystrophy (such as hypertrophy or atrophy); to prevent lipodystrophy, the client should rotate injection sites systematically.
Option D: Exercise speeds drug absorption, so the client shouldn’t inject insulin into sites above muscles that will be exercised heavily.