A patient with type 1 diabetes mellitus has been prescribed a glucagon emergency kit for home use.


When should the nurse instruct the patient and family that glucagon needs to be administered?

Choice A rationale

Decreasing cigarette use to a pack per day is not enough. Smoking can increase stomach acid and reduce the ability of the stomach lining to resist acid, thus aggravating peptic ulcer disease. Therefore, the patient should be advised to quit smoking entirely.

Choice B rationale

Lethargy could be a side effect of cimetidine. It’s important for the patient to notify the healthcare provider if they experience this, as it could indicate a need to adjust the medication.

Choice C rationale

Cimetidine should be taken with or immediately following meals for best absorption. If antacids are used, they should be taken at least one hour apart from cimetidine. Therefore, taking the medication an hour after antacids is incorrect and indicates the need for further instruction.

Choice D rationale

Sexual dysfunction is a rare but possible side effect of cimetidine. Patients should be advised to monitor for this and report any issues to their healthcare provider.

Choice A rationale

Administering glucagon intramuscularly is typically done in response to severe hypoglycemia, not for symptoms of confusion and blurred vision which are side effects of glipizide. Glucagon works by triggering the liver to release stored glucose into the bloodstream, which would not be beneficial in this case as the client’s symptoms suggest hypoglycemia, not hyperglycemia.

Choice B rationale

While measuring the client’s vital signs is an important part of overall patient assessment, it does not directly address the client’s immediate issue of confusion and blurred vision after receiving a dose of glipizide.

Choice C rationale

Obtaining a fingerstick blood glucose level is the most appropriate action. The client’s symptoms of confusion and blurred vision are common side effects of glipizide, which is used to lower blood sugar levels in people with type 2 diabetes. These symptoms may indicate that the client’s blood sugar level is too low (hypoglycemia). Checking the blood glucose level will provide immediate information about the client’s current blood sugar level and guide further interventions.

Choice D rationale

Performing a neurological exam is not the most appropriate immediate response. While confusion and blurred vision can be symptoms of neurological issues, in this context, they are likely related to the client’s recent dose of glipizide.