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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.
B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.
C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.
D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.
Correct Answer is B
Explanation
A. Increase the intake of vitamin E to enhance absorption:
While vitamin C can enhance iron absorption, vitamin E does not play a significant role in iron absorption. Vitamin C-rich foods can be advised to enhance iron absorption.
B. Iron will cause the stools to darken in color:
This statement is accurate. Iron supplements can cause stools to appear darker in color, often black or greenish-black. This change in stool color is normal and expected when taking iron supplements.
C. Take the iron with dairy products to enhance absorption:
Dairy products can inhibit iron absorption. It's better to take iron supplements with vitamin C-rich foods or orange juice to enhance absorption.
D. Limit foods high in fiber due to the risk for diarrhea:
Fiber-rich foods do not necessarily need to be limited when taking iron supplements. However, some individuals may experience constipation when taking iron supplements, in which case increasing fluid intake and dietary fiber can help alleviate constipation.
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