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) Hematuria:
While hematuria is a concerning symptom, it is not a commonly recognized adverse effect of buspirone. Hematuria might indicate other underlying conditions that need evaluation but is not typically linked to the use of buspirone.
B) Insomnia:
Insomnia is a potential adverse effect of buspirone. It can significantly impact the client’s quality of life and overall well-being. Reporting insomnia to the healthcare provider is important as it may necessitate adjustments in medication or additional interventions to help manage sleep disturbances.
C) Arthralgia:
Arthralgia, or joint pain, is not commonly associated with buspirone use. If the client experiences joint pain, it is more likely to be related to other causes rather than the medication. However, all symptoms should still be discussed with a healthcare provider.
D) Hypoglycemia:
Hypoglycemia is not a known adverse effect of buspirone. This medication does not typically influence blood glucose levels. If the client experiences symptoms of low blood sugar, other factors or conditions should be considered as potential causes.
Correct Answer is B
Explanation
A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.
B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.
C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.
D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.
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