A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance?

Choice A reason: Eating a piece of pizza is not a good option for the student. Pizza is a complex carbohydrate that contains fat and protein, which can delay the absorption of glucose and cause unpredictable blood sugar levels. The student needs a simple carbohydrate that can quickly raise her blood sugar level, such as glucose tablets, fruit juice, or candy.

Choice B reason: Taking an extra dose of rapid-acting insulin is a dangerous option for the student. Insulin lowers the blood sugar level, and the student already has symptoms of hypoglycemia (low blood sugar), such as headache, vision changes, and anxiety. Taking more insulin can worsen her condition and cause seizures, coma, or death.

Choice C reason: Eating 15 g of simple carbohydrates is the best option for the student. Simple carbohydrates are easily digested and absorbed into the bloodstream, and can raise the blood sugar level within 15 minutes. The student should eat 15 g of simple carbohydrates, such as four glucose tablets, half a cup of fruit juice, or three pieces of hard candy, and then check her blood sugar level if possible.

Choice D reason: Drinking some diet pop is not a helpful option for the student. Diet pop does not contain any sugar or calories, and will not affect the blood sugar level. The student needs a source of glucose to treat her hypoglycemia, and diet pop will not provide that.

Choice A reason: A 68-year-old patient with type 2 diabetes who has peripheral neuropathy and complains of burning foot pain is not the most urgent patient to assess. Peripheral neuropathy is a complication of diabetes that affects the nerves, especially in the feet and legs. It can cause symptoms such as numbness, tingling, burning, or pain. The nurse should assess the patient's foot condition, provide pain relief, and educate the patient on foot care. However, this patient is not in immediate danger, and can wait until the nurse finishes assessing the more critical patient.

Choice B reason: A 35-year-old patient with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL is not the most critical patient to assess. Type 1 diabetes is a condition where the pancreas does not produce any insulin, a hormone that helps the cells use glucose for energy. Patients with type 1 diabetes need to take insulin injections or use an insulin pump to control their blood glucose level. A blood glucose reading of 230 mg/dL is above the normal range of 70 to 130 mg/dL before meals, and indicates hyperglycemia (high blood sugar). The nurse should check the patient's insulin dose, monitor the patient's symptoms, and provide education on blood glucose management. However, this patient is not in life-threatening condition, and can wait until the nurse attends to the more serious patient.

Choice C reason: A 60-year-old patient with hyperosmolar hyperglycemic syndrome with dry oral mucosa and low urine output is the most important patient to assess. Hyperosmolar hyperglycemic syndrome (HHS) is a severe complication of diabetes that occurs when the blood glucose level is extremely high, usually above 600 mg/dL. HHS can cause dehydration, electrolyte imbalance, and coma. Dry oral mucosa and low urine output are signs of dehydration, which can lead to shock and organ failure. The nurse should assess the patient's vital signs, blood glucose level, fluid and electrolyte status, and neurological function. The nurse should also administer intravenous fluids, insulin, and electrolytes as prescribed by the health care provider. This patient is in a medical emergency, and needs immediate intervention.

Choice D reason: A 19-year-old patient with type 1 diabetes who was admitted with possible dawn phenomenon is not the most acute patient to assess. Dawn phenomenon is a condition where the blood glucose level rises in the early morning, usually between 2:00 AM and 8:00 AM. This is due to the release of hormones that increase the blood glucose level, such as growth hormone, cortisol, and glucagon. The nurse should review the patient's blood glucose records, adjust the insulin dose or timing, and provide education on how to prevent or manage the dawn phenomenon. However, this patient is not in a critical situation, and can wait until the nurse evaluates the more unstable patient.