A nurse is caring for a client who has diabetes mellitus and is experiencing a mild hypoglycemic reaction. Which of the following snacks should the nurse offer the client that contains 15 g of carbohydrates?

A. Moist mucous membranes: While moist mucous membranes may indicate adequate hydration, they are not specific to the treatment of hypocalcemia. The goal of hypocalcemia treatment is to correct calcium levels in the body, which would be reflected by the resolution of clinical signs related to low calcium, such as Chvostek's sign.
B. Negative Chvostek's sign: Chvostek's sign is a clinical sign that suggests hypocalcemia, where tapping the facial nerve causes twitching of the facial muscles. A negative Chvostek's sign indicates that calcium levels have normalized, meaning the treatment for hypocalcemia has been effective. The absence of this sign is a reliable indicator that the treatment has corrected the calcium deficiency.
C. Weight gain: Weight gain is not a typical or direct indicator of hypocalcemia treatment success. While some treatments for hypocalcemia might impact overall metabolism, weight gain is not a specific or reliable sign of calcium normalization. The most relevant sign would be the absence of symptoms related to calcium deficiency, such as a negative Chvostek’s sign.
D. Urine output 25 mL/hr: Urine output of 25 mL/hr is below the normal threshold, which is typically at least 30 mL/hr. While urine output can be affected by various factors, it is not a reliable marker for effective treatment of hypocalcemia. Treatment success is better assessed by signs related to calcium levels, such as the negative Chvostek’s sign, rather than urine output.

• Malabsorption syndrome: While steatorrhea indicates fat malabsorption, this diagnosis is too general. The client’s symptoms are more likely linked to recent pelvic radiation, making a treatment-induced etiology more probable. There is no evidence of chronic GI disease or a primary malabsorption disorder that predates cancer treatment.
• Tumor lysis syndrome: Typically presents with hyperuricemia, hyperkalemia, and acute kidney injury due to rapid tumor breakdown, not GI symptoms. The client’s vital signs and urine output are stable, with no lab evidence of metabolic abnormalities or renal failure.
• Radiation enteritis: Caused by radiation damage to the small bowel, common in pelvic cancer treatments like for endometrial cancer. Symptoms such as nausea, steatorrhea, abdominal pain, and anorexia strongly support this diagnosis, especially within a week of initiating radiation.

• Steatorrhea : Fatty stools indicate impaired fat absorption due to inflammation of the intestinal lining, consistent with radiation-induced enteritis. This is a key symptom supporting a diagnosis related to intestinal damage from radiation.
• Metallic taste: Common with chemotherapy but non-specific; it does not indicate the underlying cause of malabsorption or abdominal discomfort. While notable, it’s not as critical as steatorrhea for identifying radiation enteritis.
• Constipation: The client reports two bowel movements today, so constipation is not present and contradicts the clinical picture. Steatorrhea, rather than absence of bowel movements, suggests increased motility or malabsorption.