A client in emergency department (ED) is unconscious due to severe hypoglycemia. Which drug would the nurse administer?
Glucagon
Exenatide
Metformin
Glipizide
The Correct Answer is A
Rationale:
A. In an unconscious client with severe hypoglycemia, rapid correction of blood glucose is critical to prevent brain injury and other complications. Because the client cannot safely swallow, oral glucose is not an option, making parenteral administration of glucagon (IM, subcutaneous, or IV) the treatment of choice. Glucagon works by stimulating glycogenolysis in the liver, quickly raising blood glucose levels and restoring consciousness.
B. Exenatide is a GLP-1 receptor agonist used for long-term glycemic control in type 2 diabetes. It enhances insulin secretion and suppresses glucagon release in response to meals. Administering exenatide in a hypoglycemic client would worsen the hypoglycemia, potentially leading to seizures or death. It is not an emergency treatment for low blood sugar.
C. Metformin is an oral antidiabetic agent that decreases hepatic glucose production and increases peripheral insulin sensitivity. It does not raise blood glucose levels and therefore cannot correct hypoglycemia. Giving metformin to a hypoglycemic patient would be ineffective and potentially dangerous because it delays urgent correction of low glucose.
D. Glipizide is a sulfonylurea that stimulates insulin secretion from pancreatic beta cells. Administering it to a patient who is already hypoglycemic would further lower blood glucose, exacerbating the emergency situation and increasing the risk of seizures, coma, or death. It is contraindicated in acute hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["11"]
Explanation
Step 1: Convert the patient’s weight to kilograms
Weight in kg = 231 ÷ 2.2 ≈ 105 kg
Step 2: Calculate the insulin dose in units per hour
Dose (units/hr) = 0.1 units/kg/hr × 105 kg = 10.5 units/hr
Step 3: Determine the concentration from the insulin label (typically, insulin is supplied as 100 units/100 mL for IV infusion unless otherwise specified; if we assume 1 unit/mL)
mL/hr = Units/hr ÷ Concentration (units/mL)
Assuming 1 unit/mL:
mL/hr = 10.5 ÷ 1 ≈ 11 mL/hr
Final Answer: 11 mL/hr
Correct Answer is C
Explanation
Rationale:
A. Ertugliflozin is an SGLT2 inhibitor, which increases glucose excretion in the urine and naturally increases urinary output (polyuria). Fluid restriction is not recommended, as it can worsen dehydration, hypotension, or electrolyte imbalance. Adequate hydration is important.
B. Ertugliflozin typically causes mild reductions in blood pressure due to osmotic diuresis and natriuresis. Hypertension is not a common adverse effect.
C. SGLT2 inhibitors increase urinary glucose excretion, which creates an environment conducive to genital fungal infections (candidiasis). Patients should be taught to: Monitor for itching, discharge, redness, or discomfort, report symptoms promptly and practice good hygiene to help prevent infections
D. SGLT2 inhibitors may actually cause mild diuresis and volume loss, not fluid retention. Swelling or edema is not expected and should be evaluated if it occurs, as it may indicate another condition.
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