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Questions and Answers
An RN is delegating tasks to a PN regarding a client with an insulin pump. Which task related to the insulin pump can the RN safely delegate to the PN, assuming the PN has received proper training?
An RN is delegating tasks to a PN regarding a client with an insulin pump. Which task related to the insulin pump can the RN safely delegate to the PN, assuming the PN has received proper training?
- Adjusting the basal rate of the insulin pump based on client's current blood glucose level.
- Determining the appropriate bolus dosage based on carbohydrate intake.
- Educating the client and family about the function and use of the insulin pump.
- Initiating insulin administration via the pump and monitoring the client's response. (correct)
Which action demonstrates adherence to safety protocols when preparing to administer insulin via an insulin pump?
Which action demonstrates adherence to safety protocols when preparing to administer insulin via an insulin pump?
- Confirming the client's name and birth date by verbally asking the client.
- Keeping the insulin vial in direct sunlight to ensure it remains at the correct temperature.
- Reviewing the client's medical record for allergies, medical history, and pertinent lab values. (correct)
- Checking the client's allergy status only if they have a known history of allergies.
Before initiating insulin pump therapy, a nurse reviews the client's history and current status. Which assessment finding is most critical to note prior to starting the infusion?
Before initiating insulin pump therapy, a nurse reviews the client's history and current status. Which assessment finding is most critical to note prior to starting the infusion?
- The client's known allergies, especially to latex or skin antiseptics. (correct)
- The last time the client ate a meal.
- The client's occupation and daily activity level.
- The client's preference for insertion site location.
A nurse is preparing an insulin pump for a client. After inserting the insulin cartridge, which action should the nurse perform next to ensure proper function of the pump?
A nurse is preparing an insulin pump for a client. After inserting the insulin cartridge, which action should the nurse perform next to ensure proper function of the pump?
During the insertion of an insulin pump needle, a nurse notes the client grimaces and reports sharp pain. What is the most appropriate immediate action?
During the insertion of an insulin pump needle, a nurse notes the client grimaces and reports sharp pain. What is the most appropriate immediate action?
A nurse has just initiated insulin administration via an insulin pump for a client. What is the priority nursing action immediately following the insertion?
A nurse has just initiated insulin administration via an insulin pump for a client. What is the priority nursing action immediately following the insertion?
A client receiving insulin via a pump suddenly becomes diaphoretic and confused. What is the nurse's first action?
A client receiving insulin via a pump suddenly becomes diaphoretic and confused. What is the nurse's first action?
A client is being discharged home with a newly inserted insulin pump. Which instruction should the nurse emphasize during client education?
A client is being discharged home with a newly inserted insulin pump. Which instruction should the nurse emphasize during client education?
How does the use of an insulin pump primarily differ from traditional insulin injections in managing a clients diabetes?
How does the use of an insulin pump primarily differ from traditional insulin injections in managing a clients diabetes?
A client prescribed insulin via pump is scheduled for an MRI. What action should the nurse take regarding the insulin pump?
A client prescribed insulin via pump is scheduled for an MRI. What action should the nurse take regarding the insulin pump?
During routine assessment of a client with an insulin pump, a nurse notices redness and swelling at the insertion site. What is the priority action?
During routine assessment of a client with an insulin pump, a nurse notices redness and swelling at the insertion site. What is the priority action?
Which step is part of the 'planning' phase when preparing to administer insulin via an insulin pump?
Which step is part of the 'planning' phase when preparing to administer insulin via an insulin pump?
Which of the following actions taken by the nurse demonstrates adherence to infection control guidelines during insulin pump insertion?
Which of the following actions taken by the nurse demonstrates adherence to infection control guidelines during insulin pump insertion?
A nurse is teaching a client about recognizing the signs and symptoms of hyperglycemia. Which manifestations should the nurse include in the teaching?
A nurse is teaching a client about recognizing the signs and symptoms of hyperglycemia. Which manifestations should the nurse include in the teaching?
Prior to initiating insulin via an insulin pump, the nurse checks the clients medication record. Which medication would be the greatest concern?
Prior to initiating insulin via an insulin pump, the nurse checks the clients medication record. Which medication would be the greatest concern?
A client with an insulin pump is preparing to exercise. How should the nurse advise the client to manage their insulin delivery during exercise?
A client with an insulin pump is preparing to exercise. How should the nurse advise the client to manage their insulin delivery during exercise?
A nurse is educating a client on proper disposal of used insulin pump supplies at home. Which instruction is most important to emphasize?
A nurse is educating a client on proper disposal of used insulin pump supplies at home. Which instruction is most important to emphasize?
Which action should the nurse prioritize to ensure client safety before leaving the room after initiating insulin via an insulin pump?
Which action should the nurse prioritize to ensure client safety before leaving the room after initiating insulin via an insulin pump?
A client with a history of brittle diabetes is prescribed insulin via an insulin pump. What is the primary benefit of using a pump in this scenario compared to traditional injections?
A client with a history of brittle diabetes is prescribed insulin via an insulin pump. What is the primary benefit of using a pump in this scenario compared to traditional injections?
A nurse is caring for a client using an insulin pump. Which blood glucose reading would require the most immediate intervention, assuming the target range is 80-130 mg/dL?
A nurse is caring for a client using an insulin pump. Which blood glucose reading would require the most immediate intervention, assuming the target range is 80-130 mg/dL?
When preparing the insertion site for an insulin pump, which cleansing technique is recommended?
When preparing the insertion site for an insulin pump, which cleansing technique is recommended?
A client with an insulin pump reports persistent hyperglycemia despite troubleshooting the pump and following prescribed settings. What is the next appropriate step?
A client with an insulin pump reports persistent hyperglycemia despite troubleshooting the pump and following prescribed settings. What is the next appropriate step?
A nurse observes a UAP checking a client's blood glucose level. Which action by the UAP would require immediate intervention by the nurse?
A nurse observes a UAP checking a client's blood glucose level. Which action by the UAP would require immediate intervention by the nurse?
A nurse is about to insert an insulin pump needle . Which angle of insertion is most appropriate for subcutaneous administration?
A nurse is about to insert an insulin pump needle . Which angle of insertion is most appropriate for subcutaneous administration?
Which documentation entry demonstrates accurate and complete recording after initiating insulin via an insulin pump?
Which documentation entry demonstrates accurate and complete recording after initiating insulin via an insulin pump?
After initiating insulin via an insulin pump, a client reports feeling anxious and overwhelmed by the technology. What is the most appropriate nursing intervention?
After initiating insulin via an insulin pump, a client reports feeling anxious and overwhelmed by the technology. What is the most appropriate nursing intervention?
A client using an insulin pump is admitted to the hospital for a non-related condition. Who is primarily responsible for managing the client's insulin pump therapy during their hospital stay?
A client using an insulin pump is admitted to the hospital for a non-related condition. Who is primarily responsible for managing the client's insulin pump therapy during their hospital stay?
A client about to receive insulin via an insulin pump asks the nurse why this method was chosen over traditional injections. Which response is most appropriate?
A client about to receive insulin via an insulin pump asks the nurse why this method was chosen over traditional injections. Which response is most appropriate?
A nurse is evaluating a site for insulin pump insertion. Which of the following sites should the nurse avoid?
A nurse is evaluating a site for insulin pump insertion. Which of the following sites should the nurse avoid?
Flashcards
Insulin Pump
Insulin Pump
Continuous subcutaneous insulin infusion using a pump.
Allergy Check Rationale
Allergy Check Rationale
Checking for allergies prevents adverse reactions.
Client Identification
Client Identification
Verifying the client's identity ensures correct procedure.
Infection Control
Infection Control
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Review Client's Record
Review Client's Record
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Skin Cleansing
Skin Cleansing
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Reviewing Medical Record
Reviewing Medical Record
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Obtain Supplies
Obtain Supplies
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Provide Privacy
Provide Privacy
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Introduce Yourself
Introduce Yourself
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Hand Hygiene
Hand Hygiene
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Confirm Allergy Status
Confirm Allergy Status
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Client Education
Client Education
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Blood Glucose Alteration
Blood Glucose Alteration
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Triple Check Insulin
Triple Check Insulin
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Check Tubing for Bubbles
Check Tubing for Bubbles
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Apply Sterile Dressing
Apply Sterile Dressing
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Discard Needles
Discard Needles
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Monitor Blood Glucose
Monitor Blood Glucose
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Hypo/Hyperglycemia Response
Hypo/Hyperglycemia Response
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Accurate Documentation
Accurate Documentation
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Study Notes
Insulin Pump Use
- An insulin pump delivers a continuous dose of insulin into the subcutaneous tissue.
- Insulin pumps typically infuse a low dose as a basal rate.
- Pumps deliver bolus doses of insulin when needed.
- A trained practical nurse (PN) can initiate and monitor insulin pump administration as delegated by an RN.
- Assistive personnel (AP) can check blood glucose levels.
- AP cannot initiate or adjust insulin pumps.
Safety Considerations
- Determine if the client has allergies to prevent allergic reactions.
- Verify client identification to ensure the correct procedure on the correct client.
- Use standard infection control precautions to prevent transmission of infectious organisms.
- Review the client’s medical record to be aware of current health status.
- Nonsterile gloves and PPE are needed when contact with blood or body fluids is possible.
- Cleanse the skin with a facility-approved antiseptic to reduce infection risk.
Equipment
- Prefilled insulin syringe/reservoir provides the insulin source for the pump.
- The insulin pump controls the insulin dosing.
- An insulin needle accesses the client’s subcutaneous tissue, often provided in a device-specific kit.
- Dressing supplies keep the access site clean and free from microorganisms.
Step-by-Step Procedure
- Review the client’s medical record for allergies, medical history, medications, vital signs, and lab values.
- Check the medication and prescribed dose.
- Obtain all necessary supplies and ensure they are clean and working.
- Providing privacy maintains client confidentiality.
- Introduce yourself to the client to promote a therapeutic relationship.
- Hand hygiene is an important infection control measure.
- Identify the client using two unique identifiers according to facility protocol.
- Confirm the client’s allergy status because it is a safety measure to prevent allergic reaction.
- Educate the client to decrease anxiety and foster the nurse-client relationship.
- Check for indications of altered blood glucose, such as sweating, shaking, confusion (hypoglycemia), or increased thirst and urination (hyperglycemia).
- Prepare the insulin vial or remove the prepackaged syringe or cartridge.
- Follow facility protocol for triple-checking and labeling the insulin.
- Keep medication in sight at all times to reduce contamination and errors.
- Attach sterile tubing to the syringe or cartridge and insert into the pump (follow manufacturer’s directions).
- Prime the tubing per manufacturer’s instructions.
- Program the insulin pump as prescribed.
- Check the tubing for bubbles to ensure correct dosing.
- Activate the delivery device and place the needle in the insertion device, and apply downward pressure until a click is heard.
- Position the client, exposing the administration site.
- Cleanse the injection site with an antimicrobial swab in a circular motion, moving outward and allow to dry fully.
- Remove the paper adhesive backing and needle guard; pinch the skin at the insertion site and press the insertion device to the site, activating the release button.
- Apply a sterile, occlusive dressing over the insertion site and attach the pump to the client’s clothing.
- Discard used needles in appropriate receptacles to prevent injury and transmission of microorganisms.
- Promote client comfort by assisting the client to a comfortable position.
- Discuss findings with the client to reduce anxiety and foster the nurse-client relationship.
- Before leaving, ensure client safety (call light in reach, bed lowered, needed items accessible).
- Monitor the client’s blood glucose at prescribed times, as this allows for early identification of hypo- or hyperglycemia.
Interventions for Unexpected Outcomes
- For hypoglycemia symptoms (sweating, shaking, confusion) or hyperglycemia (increased thirst/urination), follow facility protocols and notify the provider.
Documentation
- Document relevant information in the client’s medical record, including interventions and findings.
- Accurate and timely documentation provides immediate access to client data for the healthcare team.
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Description
Learn about insulin pump administration, including continuous basal rates and bolus doses. Understand the roles of trained practical nurses and assistive personnel in monitoring and blood glucose checks. Review safety considerations, including allergy checks and infection control.
