A client has been brought to the emergency department by paramedics after being found unconscious. The client's Medic Alert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?
IV administration of 50% dextrose in water
IV bolus of 5% dextrose in 0.45% NaCI
Administer 4 oz. clear juice
Subcutaneous administration of 12 to 15 units of regular insulin
The Correct Answer is A
A. IV administration of 50% dextrose in water:
This is the correct answer. The client is severely hypoglycemic, and IV administration of 50% dextrose in water is the most rapid way to raise the blood glucose level in an emergency situation.
B. IV bolus of 5% dextrose in 0.45% NaCl:
While this solution contains dextrose, it is not as concentrated as 50% dextrose. In an emergency, a more concentrated solution is needed to rapidly correct severe hypoglycemia.
C. Administer 4 oz. clear juice:
Oral intake may be too slow in this critical situation. IV administration is more appropriate for rapidly raising the blood glucose level.
D. Subcutaneous administration of 12 to 15 units of regular insulin:
This would further lower the blood glucose level and is not appropriate for treating severe hypoglycemia.
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Related Questions
Correct Answer is C
Explanation
A. Persistently cold feet:
This may be a sign of poor circulation, which is more associated with peripheral vascular disease than neuropathy.
B. Acute pain, unrelieved by rest:
Acute pain is not typically associated with peripheral neuropathy. Neuropathic pain is often chronic and may include sensations like tingling or burning.
C. The presence of a tingling sensation:
This is correct. Tingling sensations, along with numbness and pain, are common symptoms of peripheral neuropathy in diabetes.
D. Pain that does not respond to analgesia:
While neuropathic pain can be challenging to manage, the primary focus is on the characteristic nature of the pain (tingling, burning) rather than its response to analgesics.
Correct Answer is B
Explanation
A.Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.
B.Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.
C.Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.
D.Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.
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