Insulin Management for Diabetic Clients: NCLEX Review

Insulin Administration

• Rotate injection sites within the same body region
• SubQ injection at 90° angle (45° for thin clients)
• Do NOT massage injection site
• Regular insulin is the ONLY insulin given IV
• Draw clear (regular) before cloudy (NPH)

Hypoglycemia vs Hyperglycemia

• Hypoglycemia (BG <70): Tremors, diaphoresis, tachycardia, confusion, hunger. Treat with 15g fast-acting carbs (4 oz juice, glucose tablets), recheck in 15 min
• Hyperglycemia (BG >250): Polyuria, polydipsia, polyphagia, fruity breath (DKA). Treat with insulin, fluids

Sick Day Rules

• Continue taking insulin (do NOT skip)
• Check blood glucose every 4 hours
• Drink plenty of fluids
• If unable to eat, substitute with clear liquids containing carbs
• Call provider if BG >300 or ketones present

Learn more at Endocrine Disorders cheat sheet and Endocrine Nursing deep dive.