The Patient has a nutritional dose of Humalog insulin of 5 units before each meal, plus Humalog insulin per sliding scale.
Blood Glucose Level sliding scale
(mg per dL) Humalog Insulin
If less than 70 and symptomatic administer 1 mg Glucagon IM then call MD 150-200 2 units
201-250 4 units
251-300 6 units
301-350 8 units
351-40010 units
Greater than 400 Call MD
The patient's meal has been delivered. the nurse checks the patient's pre-meal blood sugar, and the result is 64 mg/dL.
The patient is awake, and alert. and able to swallow. The next step the nurse should take is:
Call the MD.
Administer 1 mg Glucagon IM.
Administer 5 units of Humalog insulin.
Encourage the patient to eat their meal.
The Correct Answer is B
Since the patient's blood glucose level is less than 70 mg/dL and they are symptomatic, the first step is to administer 1 mg Glucagon IM. This will help increase the patient's blood glucose level quickly.
After administering Glucagon, the nurse should then call the MD to report the low blood glucose level and discuss any necessary adjustments to the patient's insulin regimen. It is important to note that in this situation, administering Humalog insulin would further lower the patient's blood glucose level and could worsen their symptoms. Encouraging the patient to eat their meal is also important, but it should be done after the administration of Glucagon to help maintain their blood glucose level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The initial management of DKA involves fluid resuscitation with intravenous normal saline to correct dehydration and electrolyte imbalances. Therefore, starting an infusion of normal saline at 125 ml/hr is the first prescribed action the nurse should implement.
Bringing the patient a meal is not a priority at this time because the patient's blood glucose levels need to be stabilized before they can safely consume food. Administering Lantus insulin IV and giving sodium bicarbonate 50 mEq IV push are also not the first-line treatments for DKA. Lantus insulin is a long-acting insulin used to treat hyperglycemia over an extended period and should not be given intravenously. Sodium bicarbonate may be used to correct acidosis, but it is not the first priority in DKA management.
Correct Answer is A
Explanation
In acute adrenal insufficiency, also known as Addison's disease, the adrenal glands are unable to produce enough cortisol and aldosterone hormones. These hormones play an important role in regulating sodium and potassium levels in the body. Therefore, a patient with acute adrenal insufficiency may have low sodium and high potassium levels in their blood.
The goal of therapy is to replace the deficient hormones and normalize the electrolyte levels in the body. If the current therapies are effective, the nurse would expect to see an increase in the patient's serum sodium levels because of aldosterone replacement therapy. Therefore, option a is the correct answer.
Decreasing serum chloride levels and decreasing blood glucose levels are not directly related to the treatment of acute adrenal insufficiency. In fact, a patient with acute adrenal insufficiency may have low serum chloride levels and low blood glucose levels due to the lack of cortisol hormone.
Increasing serum potassium levels would be an indicator of ineffective treatment or inadequate aldosterone replacement therapy, as aldosterone helps to regulate potassium levels in the body.
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