The nurse has administered 12 units of regular insulin to a client with type 1 diabetes at 0700. Which meal would prevent the client from experiencing hypoglycemia due to this administration?

Breakfast

Supper

Lunch

Snack

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Regular insulin peaks within 2-4 hours after administration. Therefore, to prevent hypoglycemia due to the insulin administered at 0700, the client should eat breakfast within 1-2 hours of insulin administration. This will ensure that there is glucose available in the bloodstream to match the insulin's action and prevent blood sugar levels from dropping too low.

Breakfast is the most important meal of the day, especially for individuals with diabetes. It helps to regulate blood sugar levels throughout the morning and can even help with weight management and overall health.

Skipping breakfast can lead to fluctuations in blood sugar levels and increase the risk of hypoglycemia, especially after insulin administration.

Choice B rationale:

Supper, typically consumed in the evening, would not be timely enough to prevent hypoglycemia due to the 0700 insulin administration. The insulin's peak action would have already subsided by that time, and the client would be at risk for hyperglycemia (high blood sugar) instead.

Choice C rationale:

Lunch, typically consumed around noon, would also be too late to prevent hypoglycemia from the 0700 insulin administration. The insulin's peak action would have already passed, and the client would be more likely to experience hyperglycemia.

Choice D rationale:

A snack, while it can provide some glucose, is not a substitute for a balanced meal like breakfast. Snacks often contain less protein and fiber, which are essential for slowing down glucose absorption and maintaining blood sugar stability. Relying solely on snacks to prevent hypoglycemia is not a reliable strategy for long-term blood sugar management.

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Correct Answer is A

Explanation

Choice A rationale:

Glucagon directly addresses the underlying issue of severe hypoglycemia: In a patient with Type 1 diabetes mellitus, a blood glucose level of 40 mg/dL signifies a critical condition known as severe hypoglycemia. This condition occurs when blood sugar levels drop dangerously low, depriving the brain and other vital organs of glucose, their primary source of energy. Glucagon, a hormone that acts opposite to insulin, is the most effective and rapid treatment for severe hypoglycemia. It works by stimulating the liver to release stored glucose into the bloodstream, quickly raising blood sugar levels and restoring normal brain function.

Rationale for other choices:

Choice B: Give orange juice: While orange juice contains carbohydrates that can raise blood sugar, it is not ideal for treating severe hypoglycemia due to its slower absorption rate compared to glucagon. In an unconscious patient, there's also a risk of aspiration if given orally.

Choice C: Perform CPR: CPR is not indicated in this scenario as the patient has a pulse. CPR is a lifesaving technique that is only used when a person's heart has stopped beating.

Choice D: Give insulin: Insulin, which lowers blood glucose, would be contraindicated in this situation as the patient is already experiencing severe hypoglycemia. Administering insulin would further decrease blood sugar levels, worsening the patient's condition.

Key points to remember:

Severe hypoglycemia is a medical emergency that requires prompt treatment with glucagon.

Glucagon is the only medication that can effectively and quickly raise blood glucose levels in severe hypoglycemia. It's crucial to administer glucagon as soon as possible to prevent irreversible brain damage or even death.

Healthcare professionals should be proficient in recognizing the signs and symptoms of severe hypoglycemia and administering glucagon appropriately.

A. Administer 0.4 mg of nitroglycerin SL. B. Notify the provider of the patient’s vital signs. C. Give nitroglycerin by translingual spray. D. Administer 10 units NPH insulin.

Correct Answer is B

Explanation

Rationale for Choice A:

Repeating the dose of nitroglycerin SL is not recommended at this time due to the patient's hypotension (blood pressure of 88/68 mmHg).

Administering additional nitroglycerin could further lower the blood pressure, potentially leading to adverse consequences such as dizziness, lightheadedness, or even fainting.

It's crucial to prioritize patient safety and avoid actions that could exacerbate their condition. Rationale for Choice B:

Notifying the provider is the most appropriate action in this situation for several reasons:

The patient's chest pain has not been relieved by the initial dose of nitroglycerin, indicating a need for further evaluation and potential adjustments to the treatment plan.

The patient's blood pressure is low, which warrants close monitoring and possible intervention to prevent complications.

The provider can assess the patient's overall clinical picture, including other symptoms and medical history, to determine the best course of action.

Early notification allows for timely interventions and potential prevention of further complications. Rationale for Choice C:

While nitroglycerin by translingual spray may be considered in some cases of persistent angina, it's not the most appropriate choice in this situation due to the patient's hypotension.

The translingual spray can also have a rapid onset of action, which might further lower the blood pressure if not carefully monitored.

It's essential to consider the patient's overall hemodynamic status before administering any medication that could potentially affect blood pressure.

Rationale for Choice D:

Administering NPH insulin is not relevant to the management of angina or chest pain.

Insulin is used to treat hyperglycemia in patients with diabetes, and its administration would not address the underlying issue of the patient's chest pain.

It's important to select interventions that are directly targeted at the patient's presenting symptoms and condition.

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The nurse has administered 12 units of regular insulin to a client with type 1 diabetes at 0700. Which meal would prevent the client from experiencing hypoglycemia due to this administration?

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Naxlex Comprehensive Predictor Exams

A client is brought to the emergency room unconscious, with a pulse, and with a blood glucose of 40. The client is wearing a Medic-Alert bracelet indicating that he has Type 1 diabetes mellitus.What order should the nurse anticipate?

Correct Answer is A

Explanation

A patient with angina has been given 0.4 mg of nitroglycerin SL and reports continued chest pain 5 minutes later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. What action should the nurse take next?

Correct Answer is B

Explanation

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