Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

Choice A rationale:

Glucagon directly addresses the underlying issue of severe hypoglycemia: In a patient with Type 1 diabetes mellitus, a blood glucose level of 40 mg/dL signifies a critical condition known as severe hypoglycemia. This condition occurs when blood sugar levels drop dangerously low, depriving the brain and other vital organs of glucose, their primary source of energy. Glucagon, a hormone that acts opposite to insulin, is the most effective and rapid treatment for severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, quickly raising blood sugar levels and restoring normal brain function.

Rationale for other choices:

Choice B: Give orange juice: While orange juice contains carbohydrates that can raise blood sugar, it is not ideal for treating severe hypoglycemia due to its slower absorption rate compared to glucagon. In an unconscious patient, there's also a risk of aspiration if given orally.

Choice C: Perform CPR: CPR is not indicated in this scenario as the patient has a pulse. CPR is a lifesaving technique that is only used when a person's heart has stopped beating.

Choice D: Give insulin: Insulin, which lowers blood glucose, would be contraindicated in this situation as the patient is already experiencing severe hypoglycemia. Administering insulin would further decrease blood sugar levels, worsening the patient's condition.

Key points to remember:

Severe hypoglycemia is a medical emergency that requires prompt treatment with glucagon.

Glucagon is the only medication that can effectively and quickly raise blood glucose levels in severe hypoglycemia. It's crucial to administer glucagon as soon as possible to prevent irreversible brain damage or even death.

Healthcare professionals should be proficient in recognizing the signs and symptoms of severe hypoglycemia and administering glucagon appropriately.

Choice A rationale:

Uncontrolled diabetes mellitus: Corticosteroids can have a hyperglycemic effect, meaning they can raise blood sugar levels. This makes them generally unsuitable for use in patients with uncontrolled diabetes mellitus. In fact, corticosteroids might even worsen glycemic control in these patients. While corticosteroids might be used in some cases of diabetes mellitus, such as to treat diabetic retinopathy or nephropathy, they would be used cautiously and with close monitoring of blood sugar levels.

Choice B rationale:

A recent diagnosis of lung cancer: Corticosteroids are not a primary treatment for lung cancer. They might be used in some cases to help manage symptoms or side effects of other treatments, such as chemotherapy or radiation therapy. However, they would not typically be used as a first-line treatment for lung cancer itself.

Choice C rationale:

Acute exacerbation of COPD: Corticosteroids are a mainstay of treatment for acute exacerbations of COPD. They work by reducing inflammation in the airways, which helps to improve airflow and relieve symptoms such as wheezing, shortness of breath, and chest tightness. Corticosteroids can be given orally, intravenously, or by inhalation. The dose and duration of treatment will depend on the severity of the exacerbation.

Choice D rationale:

Chronic asthma: Corticosteroids are often used as a long-term control medication for chronic asthma. However, they are typically used at lower doses than those used for acute exacerbations of COPD. Inhaled corticosteroids are the preferred form of treatment for chronic asthma, as they deliver the medication directly to the airways and have fewer systemic side effects.