A client is receiving NPH insulin 20 units subcutaneously at 0700 hours daily. At 1500 hours, the nurse finds the client apparently asleep. How would the nurse know whether the client was having a hypoglycemic reaction?
1. Feel the client and bed for dampness.
2. Observe the client for Kussmaul respirations.
3. Smell the client's breath for acetone odor.
4. Note if the client is incontinent of urine.
Rationale: (1)
When clients are sleeping, the only observable symptom of hypoglycemia is diaphoresis. Kussmaul breathing and acetone odor to breath are indicative of hyperglycemia. Incontinence is not associated with hypoglycemia and polyuria may be associated with hyperglycemia. (Lewis, Dirksen, Heitkemper, et al, 8 ed., p. 1245.)