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 C is correct because repositioning the infant every 2 hours can help expose different parts of the skin to the phototherapy light and increase the effectiveness of the treatment. The nurse should also check the skin for signs of irritation or burns.

Choice A is incorrect because feeding the infant every 4 hours is not specific to home phototherapy. The infant may need more frequent feedings depending on their hunger cues and weight gain.

Choice B is incorrect because performing diaper changes under the light is not necessary and may expose the infant's genitals to excessive light and heat. The nurse should advise the parents to cover the infant's eyes and genitals with protective shields during phototherapy.

Choice D is incorrect because covering the infant with a receiving blanket can reduce the exposure of the skin to the phototherapy light and decrease the effectiveness of the treatment. The nurse should advise the parents to keep the infant unclothed or only in a diaper during phototherapy.

A. Check for a distended bladder. B. Review the hemoglobin to determine hemorrhage. C. Massage the uterus to decrease atony. D. Increase intravenous infusion.

Correct Answer is A

Explanation

Choice B reason: Reviewing the hemoglobin to determine hemorrhage is an important action, but not the first one. The nurse should first identify and correct the cause of bleeding, such as bladder distension or uterine atony, before checking for blood loss and anemia.

Choice C reason: Massaging the uterus to decrease atony is not indicated in this case, because the uterus is already firm. Massaging a firm uterus can cause overstimulation and pain.

Choice D reason: Increasing intravenous infusion is not the first action, because it may worsen bleeding by increasing blood pressure and diluting clotting factors. The nurse should first assess and manage bleeding before administering fluids or blood products as prescribed.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

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Correct Answer is A

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