A client is brought to the emergency room unconscious, with a pulse, and with a blood glucose of 40. The client is wearing a Medic-Alert bracelet indicating that he has Type 1 diabetes mellitus.
What order should the nurse anticipate?
Give glucagon.
Give orange juice.
Perform CPR.
Give insulin.
The Correct Answer is A
Choice A rationale:
Glucagon directly addresses the underlying issue of severe hypoglycemia: In a patient with Type 1 diabetes mellitus, a blood glucose level of 40 mg/dL signifies a critical condition known as severe hypoglycemia. This condition occurs when blood sugar levels drop dangerously low, depriving the brain and other vital organs of glucose, their primary source of energy. Glucagon, a hormone that acts opposite to insulin, is the most effective and rapid treatment for severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, quickly raising blood sugar levels and restoring normal brain function.
Rationale for other choices:
Choice B: Give orange juice: While orange juice contains carbohydrates that can raise blood sugar, it is not ideal for treating severe hypoglycemia due to its slower absorption rate compared to glucagon. In an unconscious patient, there's also a risk of aspiration if given orally.
Choice C: Perform CPR: CPR is not indicated in this scenario as the patient has a pulse. CPR is a lifesaving technique that is only used when a person's heart has stopped beating.
Choice D: Give insulin: Insulin, which lowers blood glucose, would be contraindicated in this situation as the patient is already experiencing severe hypoglycemia. Administering insulin would further decrease blood sugar levels, worsening the patient's condition.
Key points to remember:
Severe hypoglycemia is a medical emergency that requires prompt treatment with glucagon.
Glucagon is the only medication that can effectively and quickly raise blood glucose levels in severe hypoglycemia. It's crucial to administer glucagon as soon as possible to prevent irreversible brain damage or even death.
Healthcare professionals should be proficient in recognizing the signs and symptoms of severe hypoglycemia and administering glucagon appropriately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Amiodarone is an antiarrhythmic medication that is often used to treat ventricular tachycardia and ventricular fibrillation. However, it is not the first-line drug for Torsades de Pointes. In fact, amiodarone can actually worsen QT prolongation and increase the risk of Torsades de Pointes.
It's important to note that amiodarone has a long half-life and can accumulate in the body over time, further increasing the risk of QT prolongation.
Additionally, amiodarone can have several serious side effects, including pulmonary toxicity, thyroid dysfunction, and liver damage.
Choice B rationale:
Lidocaine is another antiarrhythmic medication that is sometimes used to treat ventricular arrhythmias. However, it is also not the first-line drug for Torsades de Pointes.
Lidocaine is less likely to worsen QT prolongation than amiodarone, but it can still have this effect in some patients.
Additionally, lidocaine has a short half-life and must be given as a continuous infusion, which can be challenging in a critical care setting.
Choice C rationale:
Atropine is a medication that is used to increase heart rate. It is not effective in treating Torsades de Pointes and is not indicated in this situation.
Atropine works by blocking the vagus nerve, which slows heart rate. In Torsades de Pointes, the heart rate is already very fast, so atropine would not be helpful.
Additionally, atropine can have several side effects, including dry mouth, blurred vision, and urinary retention.
Choice D rationale:
Magnesium sulfate is the first-line drug for treating Torsades de Pointes. It works by stabilizing the electrical activity of the heart and preventing further episodes of arrhythmia.
Magnesium sulfate is a relatively safe medication with few side effects. It can be given as an intravenous infusion or as an intramuscular injection.
Studies have shown that magnesium sulfate is effective in terminating Torsades de Pointes and preventing recurrences.
Correct Answer is B
Explanation
Choice A rationale:
It is not recommended to take levothyroxine with food as it can interfere with its absorption.
Food, particularly those containing calcium or iron, can bind to levothyroxine in the gastrointestinal tract, reducing the amount of medication that is absorbed into the bloodstream.
This can lead to decreased effectiveness of the medication.
It's generally advised to take levothyroxine on an empty stomach, at least 30-60 minutes before breakfast, to ensure optimal absorption.
Choice B rationale:
Taking levothyroxine first thing in the morning, on an empty stomach, is the most effective way to ensure its absorption and consistent hormone levels throughout the day.
This aligns with the body's natural rhythm of thyroid hormone production, which typically peaks in the morning hours.
Taking the medication consistently at the same time each day helps maintain stable thyroid hormone levels, which is crucial for managing hypothyroidism effectively.
Choice C rationale:
Relief of symptoms with levothyroxine therapy often takes several weeks, not just one week.
It takes time for the body to adjust to the medication and for thyroid hormone levels to reach a therapeutic range.
Patients should be counseled to have patience and continue taking the medication as prescribed, even if they don't experience immediate symptom relief.
They should also be monitored regularly by their healthcare provider to assess their response to treatment and make any necessary adjustments to the dosage.
Choice D rationale:
Doubling the dose of levothyroxine without consulting a healthcare provider is dangerous and can lead to serious health consequences.
Overdosing on levothyroxine can cause hyperthyroidism, which can manifest as rapid heart rate, anxiety, tremors, weight loss, and other health problems.
It's essential to follow the prescribed dosage and not make any changes without the guidance of a healthcare professional.
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