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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A: Inspecting feet every month for ingrown nails, cuts, and calluses is not a statement that indicates understanding, as this is not frequent enough for a client with diabetes who may have impaired sensation and circulation in their feet. The recommended frequency is daily or at least weekly. This is an incorrect choice.

Choice B: Arranging diet schedule around three regular meals a day is not a statement that indicates understanding, as this may not be adequate for a client with diabetes who needs to balance their carbohydrate intake and blood glucose levels throughout the day. The recommended schedule is to have smaller and more frequent meals and snacks. This is another incorrect choice.

Choice C: Getting an eye examination with an ophthalmologist annually is a statement that indicates understanding, as this can help detect and prevent diabetic retinopathy, which can cause vision loss and blindness. Therefore, this is the correct choice.

Choice D: Using salt, herbs, and spices will improve the flavor of foods is not a statement that indicates understanding, as this may not be healthy for a client with diabetes who needs to limit their sodium intake and avoid potential interactions between herbs and medications. The recommended strategy is to use low-sodium seasonings and natural flavors. This is another incorrect choice.

A. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck. B. Provide a nebulizer treatment with bronchodilators. C. Obtain bedside trays for intubation or tracheotomy by the healthcare provider. D. Begin prescribed intravenous antibiotic administration.

Correct Answer is C

Explanation

Choice A reason: Scheduling the child for a STAT magnetic resonance imaging (MRI) of the neck is not a priority action for the nurse. MRI is a diagnostic test that uses magnetic fields and radio waves to produce images of the internal structures of the body. MRI of the neck may be useful to rule out other causes of respiratory distress, such as tumors, abscesses, or foreign bodies, but it is not an urgent procedure. Moreover, MRI requires the child to lie still for a long time, which may be difficult or impossible for a child who is anxious and in respiratory distress.

Choice B reason: Providing a nebulizer treatment with bronchodilators is not a suitable action for the nurse. Nebulizer is a device that delivers medication in the form of a mist that can be inhaled into the lungs. Bronchodilators are medications that relax the smooth muscles of the airways and improve airflow. Nebulizer treatment with bronchodilators may be helpful for children with respiratory distress caused by asthma, bronchiolitis, or chronic obstructive pulmonary disease, but not for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child.

Choice C reason: Obtaining bedside trays for intubation or tracheotomy by the healthcare provider is the most appropriate action for the nurse. Intubation is a procedure that involves inserting a tube through the mouth or nose into the trachea to secure the airway and provide ventilation. Tracheotomy is a surgical procedure that involves creating an opening in the neck and inserting a tube into the trachea to bypass the upper airway obstruction. Both procedures are life-saving interventions for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child. The nurse should prepare the necessary equipment and assist the healthcare provider in performing these procedures.

Choice D reason: Beginning prescribed intravenous antibiotic administration is not a relevant action for the nurse. Antibiotics are medications that kill or inhibit the growth of bacteria that cause infections. Antibiotics may be indicated for children with respiratory distress caused by bacterial infections, such as pneumonia, tonsillitis, or epiglottitis, but not for children with respiratory distress caused by non-infectious causes, such as foreign bodies, anaphylaxis, or congenital anomalies. Moreover, antibiotics are not an immediate intervention for respiratory distress, as they take time to exert their effects.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing teaching to a client with type 2 diabetes mellitus about important points for disease and symptom management. Which statement by the client indicates understanding?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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