The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:
15 to 20 g of a fast-acting carbohydrate such as orange juice.
I.V. bolus of dextrose 50%.
I.M. or subcutaneous glucagon.
10 U of fast-acting insulin
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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 A
Explanation
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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