A nurse is providing teaching to a client who has type 1 diabetes mellitus and her partner about how to manage severe hypoglycemia at home. Which of the following actions should the nurse instruct the partner to perform first?
Offer the client a small meal if she is not nauseated.
Administer 1 mg of glucagon intramuscularly to the client.
Contact the client's provider for further instructions
Transport the client to an emergency department for treatment.
The Correct Answer is B
A) Offer the client a small meal if she is not nauseated:
While eating a small meal can help raise blood glucose levels, it is not the immediate priority in a severe hypoglycemia situation. The client might be unconscious or unable to swallow safely, making this action inappropriate as a first step.
B) Administer 1 mg of glucagon intramuscularly to the client:
Administering glucagon intramuscularly is the most crucial initial action. Glucagon rapidly increases blood glucose levels by stimulating glycogen breakdown in the liver. This is vital for quickly reversing severe hypoglycemia, especially if the client is unconscious or unable to ingest carbohydrates orally.
C) Contact the client's provider for further instructions:
Contacting the provider is essential, but it should occur after addressing the immediate hypoglycemic episode. Once the client's condition stabilizes, further guidance can be sought from the healthcare provider.
D) Transport the client to an emergency department for treatment:
Transporting the client to the emergency department is necessary if the hypoglycemia does not improve after administering glucagon or if the client remains unresponsive. However, it is not the first action; immediate glucagon administration takes precedence to stabilize the client's condition before considering transportation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "I will offer my child apple juice instead of milk.": Offering apple juice instead of milk is not ideal for a toddler with failure to thrive. Milk is a better source of essential nutrients like calcium and vitamin D, which are important for growth and development. Juice can contribute to empty calories and should be limited.
B) "I should continue to feed my child when he pushes food out with his tongue.": This statement indicates an understanding of the importance of addressing feeding difficulties. In toddlers with Down syndrome, it is common to experience difficulties with feeding and swallowing. Continuing to offer food and using techniques to encourage eating, even when the child initially pushes food out, can help ensure adequate nutritional intake and support growth.
C) "I will provide his favorite food as a reward for good behavior.": Using food as a reward can lead to unhealthy eating habits and an association of food with behavior rather than hunger and nutrition. It’s better to use non-food rewards to encourage positive behavior.
D) "I should increase my child's vitamin A intake by feeding him raw carrot slices.": While vitamin A is important, raw carrots can be difficult for toddlers, especially those with developmental delays or oral-motor difficulties, to chew and swallow. Cooked carrots or other vitamin A-rich foods might be a safer option.
Correct Answer is D
Explanation
A) Expect optimum visual acuity to return in 4 to 6 weeks: While some improvement in vision can be noted soon after cataract surgery, optimal visual acuity typically returns within 1 to 2 months. It's important to set realistic expectations for recovery. Telling the patient to expect optimum visual acuity to return in 4 to 6 weeks provides a more accurate timeframe for complete visual recovery.
B) Notify the provider if new floaters persist for more than 3 days: The presence of new floaters can be a sign of complications such as retinal detachment or vitreous hemorrhage. However, patients are generally advised to notify their provider immediately if they notice any new floaters, flashes of light, or a sudden decrease in vision, rather than waiting for three days. Immediate notification can lead to prompt evaluation and treatment if necessary.
C) Take aspirin every 4 to 6 hr for mild discomfort: Aspirin is generally avoided postoperatively due to its blood-thinning properties, which can increase the risk of bleeding. Instead, non-aspirin pain relievers like acetaminophen are usually recommended to manage mild discomfort after cataract surgery, as they do not carry the same risk of bleeding complications.
D) Avoid lifting objects that weigh 9.07 kg (20 lb) or more: Patients are advised to avoid lifting heavy objects and engaging in strenuous activities after cataract surgery to prevent increased intraocular pressure, which can interfere with healing and potentially cause complications such as bleeding or dislocation of the intraocular lens. This instruction helps ensure the safety and proper healing of the surgical site.
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