The nurse is preparing a 50 mL dose of 50% Dextrose IV for a client with insulin shock. How should the nurse administer the medication?
Ask the pharmacist to add the Dextrose to a TPN solution.
Mix the Dextrose in a 50 mL piggyback for a total volume of 100 mL.
Push the undiluted Dextrose slowly through the currently infusing IV.
Dilute the Dextrose in one liter of 0.9% Normal Saline solution.
The Correct Answer is C
Choice C is correct because pushing the undiluted Dextrose slowly through the currently infusing IV is the best way to administer the medication for a client with insulin shock. Insulin shock is a condition in which the blood glucose level drops too low due to excess insulin or insufficient food intake. This can cause symptoms such as confusion, sweating, tremors, or loss of consciousness. The nurse should administer 50% Dextrose IV as a bolus injection to raise the blood glucose level quickly and prevent brain damage.
Choice A is incorrect because asking the pharmacist to add the Dextrose to a TPN solution is not appropriate for a client with insulin shock. TPN stands for total parenteral nutrition, which is a type of intravenous feeding that provides all the nutrients needed by the body. TPN solutions contain dextrose, amino acids, lipids, vitamins, minerals, and electrolytes in specific concentrations and ratios. Adding extra dextrose to a TPN solution can alter its composition and cause complications such as hyperglycemia or fluid overload.
Choice B is incorrect because mixing the Dextrose in a 50 mL piggyback for a total volume of 100 mL is not effective for a client with insulin shock. A piggyback is a type of intravenous infusion that delivers medication through a secondary tubing attached to the primary tubing of another solution. Mixing the Dextrose in a piggyback can dilute its concentration and reduce its potency. It can also delay its delivery and onset of action.
Choice D is incorrect because diluting the Dextrose in one liter of 0.9% Normal Saline solution is not safe for a client with insulin shock. Normal Saline is a type of intravenous fluid that contains sodium chloride in isotonic concentration. Diluting the Dextrose in one liter of Normal Saline can lower its concentration and increase its volume significantly. This can cause complications such as hypoglycemia or fluid overload.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A: Taking metformin with the morning and evening meal is a correct statement for the nurse to include, as this can improve the absorption and effectiveness of metformin and reduce the risk of gastrointestinal side effects. Therefore, this is a correct choice.
Choice B: Using sliding scale insulin for frequent blood glucose elevations is not a correct statement for the nurse to include, as this is not recommended for clients with type 2 DM who are taking metformin. This can cause hypoglycemia and complicate the management of blood glucose levels. This is an incorrect choice.
Choice C: Recognizing signs and symptoms of hypoglycemia is a correct statement for the nurse to include, as this can help the client identify and treat low blood glucose levels, which can occur with metformin use or other factors such as exercise, fasting, or alcohol intake. Therefore, this is another correct choice.
Choice D: Reporting persistent polyuria to the health care provider is a correct statement for the nurse to include, as this can indicate poor glycemic control or a complication of DM such as diabetic ketoacidosis or nephropathy. Therefore, this is another correct choice.
Choice E: Taking an additional dose for signs of hyperglycemia is not a correct statement for the nurse to include, as this can cause overdose or toxicity of metformin, which can lead to lactic acidosis and renal failure. This is another incorrect choice.
Correct Answer is ["B","C","D","F"]
Explanation
Choice A reason: Alcohol consumption will not produce vascular changes is incorrect information. Alcohol consumption can increase blood pressure by causing vasoconstriction, fluid retention, and interference with antihypertensive medications. The nurse should advise the client to limit alcohol intake to no more than one drink per day for women and two drinks per day for men.
Choice B reason: Sodium intake can be regulated by limiting canned foods in the diet is correct information. Sodium intake can increase blood pressure by causing fluid retention and increasing vascular resistance. The nurse should advise the client to limit sodium intake to no more than 2300 mg per day and avoid processed foods that are high in sodium, such as canned foods, soups, sauces, and snacks.
Choice C reason: Salt substitutes can help with maintaining a healthy diet is correct information. Salt substitutes can reduce sodium intake by replacing sodium chloride with potassium chloride or other minerals. The nurse should advise the client to use salt substitutes sparingly and consult with their healthcare provider before using them if they have kidney disease or take certain medications that affect potassium levels.
Choice D reason: Weight management is promoted by taking daily walks for thirty minutes is correct information. Weight management can lower blood pressure by reducing body fat, improving blood circulation, and enhancing insulin sensitivity. The nurse should advise the client to maintain a healthy weight and engage in moderate physical activity for at least 150 minutes per week.
Choice E reason: Blood pressure readings should be taken at noontime is incorrect information. Blood pressure readings should be taken at different times of the day, preferably in the morning and evening, to monitor fluctuations and trends. The nurse should advise the client to use a home blood pressure monitor that is accurate and calibrated and follow proper techniques for measuring blood pressure.
Choice F reason: Uncontrolled hypertension can lead to renal damage is correct information. Uncontrolled hypertension can damage the blood vessels in the kidneys, leading to reduced kidney function and chronic kidney disease. The nurse should advise the client to follow their prescribed treatment plan and monitor their blood pressure regularly.
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