A nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just after the injection, the dietary department calls to inform the patient care unit that breakfast trays will be 45 minutes late. What will the nurse do next?

Choice A rationale Simply informing the patient of the delay does not address the immediate physiological need. Lispro (Humalog) is a rapid-acting insulin with an onset of action of 15 to 30 minutes, a peak of 0.5 to 2.5 hours, and a duration of 3 to 6 hours. Waiting 45 minutes for the tray puts the patient at significant risk for hypoglycemia. Choice B rationale While checking the blood glucose level is good practice, it is not the most urgent action. The priority is to prevent hypoglycemia, which is an immediate and potentially life-threatening complication of giving rapid-acting insulin without a meal. The patient is already at risk given the time elapsed. Choice C rationale Lispro (Humalog) has a rapid onset of action, so the patient must eat within 15 to 30 minutes of administration to prevent hypoglycemia. Providing a fast-acting carbohydrate source like juice, followed by a protein and complex carbohydrate source like cereal and skim milk, will raise blood glucose levels and prevent a hypoglycemic event until the breakfast tray arrives. Choice D rationale While calling dietary to expedite the tray is a reasonable action, it may not be fast enough to prevent a hypoglycemic event. The most immediate and critical action is to provide the patient with food to counteract the rapid action of the lispro insulin. This directly addresses the patient's safety.