When should the nurse modify a client's insulin administration?

Modifying a client's insulin administration is particularly important when there is a pattern of elevated glucose readings. Elevated glucose levels can indicate that the current insulin regimen is insufficient to achieve desired blood glucose control. In such cases, the nurse must assess the client’s overall situation and may need to adjust the insulin dosage or timing to better manage their condition. This adjustment could involve increasing the dose, changing the type of insulin, or modifying the administration schedule to prevent potential complications such as hyperglycemia or diabetic ketoacidosis.

While the other situations may warrant attention or consideration, they do not directly justify an immediate modification of the insulin regimen. For instance, insulin may still be necessary even when blood glucose levels are normal, as this does not account for fluctuations or future variability. If a client has not consumed any food, they may still require a modified dose based on their overall insulin requirement and risk factors, but this is generally a more nuanced decision. Lastly, the unavailability of a physician does not constitute grounds for altering insulin administration; rather, protocols exist for managing insulin during such times, and the nurse should rely on established guidelines and their professional judgment rather than making independent changes.