A nurse is caring for a preschooler who has diabetes mellitus and is pale, diaphoretic, and irritable. The child's blood glucose level is 52 mg/dL. Which of the following actions should the nurse take first?
Give 1 tsp of peanut butter to the child.
Recheck the child's blood glucose level.
Administer 1 tbsp of sugar to the child.
Document the incident in the child's record.
The Correct Answer is C
Rationale:
A) Peanut butter is not a rapidly absorbed source of glucose and may not be appropriate for treating hypoglycemia.
B) While rechecking the child's blood glucose level is important, immediate treatment should be initiated for symptomatic hypoglycemia.
C) Administering a rapidly absorbed source of sugar, such as 1 tablespoon of sugar or honey, is the priority intervention for treating hypoglycemia in a conscious child.
D) Documenting the incident is important but should not delay the administration of treatment for hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Skin turgor assessment is important in assessing dehydration, but the priority is addressing the tachycardia first.
B. Potassium level is important in managing electrolyte imbalance in gastroenteritis, but the priority is addressing the elevated heart rate first.
C. Capillary refill is an important assessment for circulation, but the priority is addressing the elevated heart rate first.
D. The elevated heart rate (tachycardia) indicates increased workload on the heart, likely due to dehydration or other complications of gastroenteritis. This requires immediate attention to stabilize the infant's condition.
Correct Answer is ["A","C","D"]
Explanation
Rationale:
A) Installing window guards on windows prevents falls and injuries.
B) Placing scatter rugs over hardwood floors increases the risk of tripping and falls.
C) Keeping doors locked prevents access to hazardous areas or materials.
D) Supervising at playgrounds ensures the toddler's safety during play.
E) Pot handles should be turned away from the front of the stove to prevent accidental spills and burns.
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