A nurse is assessing a client who is lethargic, diaphoretic, and difficult to arouse. The client's blood sugar result was 40 mg/dL. The nurse anticipates which of the following to be administered?

Glucose tablets

Epinephrine

IVP dextrose 50%

4 oz of orange juice

Answer and Explanation

The Correct Answer is C

A. Glucose tablets are appropriate for clients with mild hypoglycemia who are alert and able to chew and swallow; they are not suitable for someone who is difficult to arouse.
B. Epinephrine is not used as a treatment for hypoglycemia; it does not directly increase blood glucose levels.
C. IVP (intravenous push) dextrose 50% is indicated for severe hypoglycemia in clients who are lethargic or unresponsive, as it rapidly increases blood glucose levels.
D. Orange juice is effective for mild hypoglycemia but is not appropriate in this case due to the client’s altered mental status and risk of aspiration.

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Correct Answer is A

Explanation

A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.
B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.
C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.
D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.

A. The drug will be most effective when given orally. B. The drug will be more effective when given in a non-enteral route. C. The drug is excreted by the kidneys at a slower rate than most medications. D. The kidney will metabolize some of the drug before it reaches the bloodstream.

Correct Answer is B

Explanation

A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.

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A nurse is assessing a client who is lethargic, diaphoretic, and difficult to arouse. The client's blood sugar result was 40 mg/dL. The nurse anticipates which of the following to be administered?

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