A nurse observes a new diabetic client self-administer insulin lispro for the first time, following client teaching. For each client behavior, click to specify whether the behavior demonstrates effective learning or that further teaching is required.

• Injects insulin into abdomen at 45-90 degree angle: Proper injection angle ensures the insulin is delivered into subcutaneous tissue, promoting optimal absorption. The abdomen is the preferred site for rapid-acting insulin like lispro. The client demonstrates correct technique, showing effective learning. • Checks blood glucose immediately prior to injection: Monitoring blood glucose before insulin administration is essential for safe dosing and avoiding hypoglycemia. The client correctly performs this step, indicating understanding of blood glucose monitoring and insulin timing. • Utilizes correct insulin syringe for injection: Using the correct syringe type ensures accurate measurement of insulin units. The client demonstrates proper selection and use, reflecting adherence to safe injection practices. • Selects site different from previous injection site: Rotating injection sites prevents lipodystrophy and maintains consistent insulin absorption. The client demonstrates correct site rotation, showing understanding of long-term injection site care. • Massages the site after removing the needle: Massaging the injection site can alter insulin absorption and may lead to bruising or tissue damage. Clients should be taught to avoid massaging immediately after injection. This indicates the client needs additional instruction. • Shakes insulin to mix it uniformly: Rapidly shaking insulin can create air bubbles and denature the protein, reducing effectiveness. Insulin should be gently rolled or inverted if mixing is needed. This behavior requires further teaching.