Question

The client is experiencing dawn phenomena associated with diabetes mellitus. Which action by the nurse indicates knowledge of dawn phenomena? A. The nurse offers peanut butter and crackers as a snack prior to bedtime. B. The nurse wakes the client during the night to check her blood glucose level. C. The nurse administers \(\mathrm{NPH}\) insulin subcutaneously as ordered. D. The nurse explains the need for frequent cortisole levels to be checked.

Short answer

Answer: Option C: Administering NPH insulin subcutaneously as ordered.

Step-by-step solution

Option A: Offering peanut butter and crackers as a snack prior to bedtime.

This action may be appropriate for some individuals with diabetes, as it provides a slow-release source of carbohydrates that can help stabilize blood glucose levels during the night. However, this measure alone may not adequately address the rise in blood sugar levels associated with dawn phenomenon.

Option B: Waking the client during the night to check her blood glucose level.

This action demonstrates that the nurse is aware of the potential for unstable blood glucose levels during the night, but it may be a disruptive and unnecessary measure for managing dawn phenomenon. Continuous glucose monitoring devices can be used to monitor blood glucose levels overnight without requiring the client to wake up.

Option C: Administering NPH insulin subcutaneously as ordered.

NPH (neutral protamine Hagedorn) insulin is an intermediate-acting insulin that is designed to be absorbed slowly into the bloodstream, providing a consistent release of insulin throughout the day and helping to smooth out fluctuations in blood glucose levels. This action may be the most appropriate choice for addressing dawn phenomenon, as it targets the underlying cause of the problem: the early morning surge in hormones that affect insulin sensitivity.

Option D: Explaining the need for frequent cortisol level checks.

Cortisol is a hormone that plays a role in regulating blood glucose, and its levels can affect the body's sensitivity to insulin. Though this helpful in understanding the cause behind dawn phenomenon, frequent cortisol level checks may not be the best measure for managing dawn phenomenon in a practical way. Considering the options, administering NPH insulin subcutaneously as ordered (Option C) would be the best action by the nurse as it demonstrates knowledge of the dawn phenomenon and provides a solution that targets the underlying cause of the problem.