A patient with type 1 diabetes has a high morning glucose measurement and the healthcare provider wants the patient evaluated for possible Somogyi effect. The nurse will plan to
obtain the patient's blood glucose level between 2a.m-4a.m
check the patient for a change in level of consciousness between 2a.m-4a.m
withhold the night time snack and check the glucose at 6:00a.m.
administer an increased dose of NPH insulin in the evening
The Correct Answer is A
A. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.
B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.
C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.
D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Dextrose 5% in 0.45% sodium chloride IV. – Incorrect. Dextrose is given later, after blood glucose drops below 250 mg/dL to prevent hypoglycemia.
B. Oral hypoglycemic medications. – Incorrect. DKA requires IV insulin, not oral medications.
C. Glucocorticoid medications. – Incorrect. Glucocorticoids can worsen hyperglycemia by increasing blood sugar.
D. 0.9% sodium chloride IV. – Correct Answer. Fluid resuscitation with normal saline is the first priority to correct hypovolemia caused by osmotic diuresis in DKA.
Correct Answer is D
Explanation
A. Bradycardia is not a typical sign of hypoglycemia; tachycardia is more common.
B. A fruity odor on the breath is a sign of diabetic ketoacidosis (DKA) (hyperglycemia).
C. Vomiting is more common in hyperglycemia/DKA rather than hypoglycemia.
D. Hypoglycemia presents with cool, clammy skin, sweating, confusion, and tremors due to the release of epinephrine.
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