A nurse is caring for a client who has chronic kidney failure. An assistive personnel reports that the client has a blood pressure of 190/110 mm Hg. Which of the following actions should the nurse take first?

Management of hypoglycemia in a client with Type 1 diabetes mellitus involves rapid recognition and prompt administration of fast-acting carbohydrates to restore blood glucose levels. Mild hypoglycemia commonly presents with symptoms such as shakiness, sweating, hunger, irritability, or dizziness when blood glucose falls below normal levels. The priority treatment for a conscious client is administration of rapidly absorbable carbohydrates that can quickly raise serum glucose. Timely intervention helps prevent progression to severe neurological impairment or loss of consciousness.

Rationale:
A. Glucagon injection is typically reserved for severe hypoglycemia when the client is unconscious, unable to swallow safely, or experiencing seizures. Since the adolescent has only mild symptoms and is presumably alert enough to take oral carbohydrates, injectable glucagon is unnecessary at this stage. Oral treatment is preferred for mild hypoglycemic episodes.

B. One teaspoon of sugar alone does not provide an adequate amount of carbohydrate to effectively correct hypoglycemia. Standard treatment recommendations usually involve approximately 15 g of rapid-acting carbohydrate. A single teaspoon contains too little glucose and may not raise serum glucose sufficiently or rapidly enough.

C. A glass of orange juice is appropriate because it contains rapidly absorbed simple carbohydrates that quickly increase blood glucose levels. Fruit juice is commonly recommended for conscious clients experiencing mild hypoglycemia due to its fast onset of action. This intervention follows the “15-15 rule” commonly used in hypoglycemia management.

D. Peanut butter is not appropriate for immediate correction of hypoglycemia because its fat and protein content slows glucose absorption. Although it may help maintain glucose levels after initial correction, it does not act quickly enough to treat acute low blood sugar. Rapid-acting carbohydrates are needed first.

Blood glucose monitoring is a routine nursing procedure used to assess a client’s glycemic status and guide diabetes management. Accurate capillary blood sampling technique is essential to obtain reliable results while minimizing discomfort and tissue injury. Proper procedure also reduces the risk of infection and ensures adequate blood flow from the puncture site. Nursing care focuses on correct site selection, aseptic technique, and avoiding actions that may distort results.

Rationale:
A. Puncturing the side of the client’s finger is correct because this area has fewer nerve endings and is less painful compared to the fingertip center. It also provides adequate capillary blood flow for accurate glucose measurement. Proper site selection improves client comfort while ensuring reliable results during monitoring of conditions such as Blood glucose monitoring.

B. Positioning the client’s finger above the heart is incorrect because it reduces blood flow to the puncture site, making it more difficult to obtain an adequate blood sample. The finger should be kept in a dependent position or gently warmed to promote capillary perfusion. Elevation may lead to insufficient sample collection and repeated punctures.

C. Milking the finger site is incorrect because it can cause tissue fluid contamination of the blood sample, leading to falsely altered glucose readings. Excessive squeezing may dilute the sample with interstitial fluid, reducing accuracy. Gentle pressure may be used, but forceful “milking” should be avoided.

D. Applying sterile gloves is not required for routine blood glucose monitoring; clean gloves are appropriate. The procedure is considered non-sterile but requires standard precautions to prevent infection. Using sterile gloves unnecessarily increases cost and is not indicated for capillary blood sampling.