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The nurse is caring for a client who is diabetic and has a blood glucose level of 30 mg/dL. The client is unconscious and has a 20-gauge peripheral IV in the antecubital area. After securing the client's airway, what medication should the nurse plan to administer first?

A.

50% Dextrose in Water (D50W) IV push

B.

Insulin Regular IV push

C.

0.9% sodium chloride infusion

D.

5% Dextrose continuous IV infusion

Answer and Explanation

The Correct Answer is A

A. 50% Dextrose in Water (D50W) IV push is the most appropriate intervention for a client with a blood glucose level of 30 mg/dL, indicating severe hypoglycemia. The rapid administration of D50W will quickly raise the blood glucose level and help restore consciousness.  
B. Insulin Regular IV push would lower the blood glucose level, which is not appropriate in this situation where the client is hypoglycemic.  
C. 0.9% sodium chloride infusion is a general fluid replacement solution, but it will not address the client's low blood glucose level.  
D. 5% Dextrose continuous IV infusion is typically used for maintenance, but it would not act as quickly as D50W to correct severe hypoglycemia in an unconscious patient.
 


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Related Questions

Correct Answer is C

Explanation

A. Hyperactive reflexes are not typically associated with hypokalemia. In fact, hypokalemia can lead to hyporeflexia (decreased reflexes) due to the role of potassium in nerve function.
B. Extreme thirst is more commonly associated with hypernatremia or dehydration, not specifically with hypokalemia.
C. A flattened T-wave on an ECG is a classic sign of hypokalemia. Potassium plays a crucial role in maintaining the electrical activity of the heart, and low potassium levels can cause changes in the ECG, including a flattened T-wave.
D. Hyperactive bowel sounds are typically seen in conditions like gastroenteritis or early bowel obstruction, not directly related to hypokalemia. In fact, hypokalemia can sometimes lead to hypoactive or absent bowel sounds due to its effect on smooth muscle function.

Correct Answer is B

Explanation

A. Administering oxygen is important, but the priority is reversing the opioid-induced respiratory depression with naloxone. Oxygen alone will not address the underlying cause of the decreased level of consciousness.
B. Administering naloxone (Narcan) is the priority intervention because it is an opioid antagonist that will reverse the effects of morphine and other opioids, improving respiratory function and consciousness.
C. Opening the airway is important, but the primary issue here is opioid overdose, which requires naloxone administration for reversal of respiratory depression.
D. Placing the patient in the shock position is not indicated in this scenario. The focus should be on reversing opioid toxicity, not on positioning for shock.

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