A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

4 oz diet soda

1 tsp sugar

4 oz skim milk

Graham crackers

Answer and Explanation

The Correct Answer is D

A. 4 oz diet soda: Diet soda contains artificial sweeteners, not real sugar, and therefore will not effectively raise blood glucose levels. It's not suitable for treating hypoglycemia.

B. 1 tsp sugar: While 1 tsp of sugar can provide some glucose, the amount is insufficient to treat hypoglycemia effectively. The American Diabetes Association recommends 15 grams of fast-acting carbohydrates, which is equivalent to about 4 teaspoons of sugar, not 1.

C. 4 oz skim milk: Skim milk contains both carbohydrates (approximately 12 grams of carbohydrates per 8 oz, so 4 oz would provide around 6 grams) and protein. While it can help raise blood glucose, it may not provide the recommended 15 grams of fast-acting carbohydrates to treat hypoglycemia quickly enough.

D. Graham crackers: Foods with a high glycemic index (GI), such as graham crackers, can cause blood sugar levels to rise relatively quickly. Graham crackers, being high in refined carbohydrates, can indeed result in a rapid increase in blood glucose levels compared to low-GI foods.

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Correct Answer is C

Explanation

A. Increased pulmonary artery wedge pressure (PAWP): PAWP measures left atrial pressure, which is typically increased in left-sided heart failure, not right-sided. Right-sided heart failure leads to systemic congestion rather than pulmonary congestion.

B. Decreased specific gravity: Specific gravity measures urine concentration. It is not a primary indicator of heart failure. Heart failure usually affects fluid balance rather than specific urine concentration.

C. Elevated central venous pressure (CVP): CVP reflects the pressure in the right atrium and central veins, which is elevated in right-sided heart failure due to the backup of blood in the systemic circulation. This results in increased venous pressure.

D. Decreased brain natriuretic peptide (BNP): BNP levels are typically elevated in heart failure, as they reflect the degree of ventricular stretching and fluid overload. A decrease would not be expected in acute heart failure.

A. Blood glucose level below 40 mg/dL B. Malignant hypertension C. Cheyne-Stokes breathing D. Acetone odor to breath

Correct Answer is D

Explanation

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.

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A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

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A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?