A nurse is preparing to administer Humalog (Lispro) insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

Choice A rationale Polyuria is a classic symptom of hyperglycemia and osmotic diuresis, not a primary adverse effect of insulin administration. The nurse should instead monitor for signs of hypoglycemia, which is the most common risk following insulin injection. While polyuria might indicate that the insulin dose was insufficient to control glucose levels, it is not an action the nurse takes as part of the direct administration process for rapid-acting Humalog insulin. Choice B rationale Humalog is a rapid-acting insulin with a peak effect occurring between 30 to 90 minutes after injection. Assessing for hypoglycemia at 4 hours would be too late, as the peak metabolic effect has already passed and the insulin’s action is tapering off. Safety protocols require monitoring for hypoglycemia much earlier, usually within 1 to 3 hours, to catch the point of maximum glucose-lowering activity and ensure the patient's safety during this peak. Choice C rationale Humalog (lispro) is a rapid-acting insulin with an onset of action approximately 15 minutes after subcutaneous injection. To prevent a hypoglycemic event, it is vital that the patient eats a meal shortly after administration. Injecting 15 minutes before the meal aligns the insulin’s peak effect with the absorption of carbohydrates from the food, thereby maintaining stable postprandial blood glucose levels and preventing the blood sugar from dropping too low before food is consumed. Choice D rationale Humalog is already a rapid-acting insulin used for bolus coverage; it is frequently paired with intermediate or long-acting insulin to provide basal coverage, but it is not typically administered "with" another short-acting insulin simultaneously for the same purpose. Mixing or co-administering with regular insulin (short-acting) is redundant and increases the risk of unpredictable glucose drops. The nurse focuses on the timing of this specific rapid-acting dose relative to food intake.