The nurse teaches a client to store unopened insulin vials. Which statement shows correct understanding?

Rationale:

A. Keeping a patient NPO while they are hypoglycemic is unsafe. Hypoglycemia can rapidly progress and lead to seizures, loss of consciousness, or death. Immediate treatment of low blood glucose takes priority over fasting for labs.

B. Waiting to contact the provider delays treatment. Mild hypoglycemia with symptoms requires immediate intervention. Delaying action could allow the blood glucose to drop further, increasing risk for severe complications.

C. While monitoring is important, waiting an hour without intervening does not address the current hypoglycemia. Mild hypoglycemia should be treated immediately, then rechecked in 15 minutes after treatment.

D. The “15-15 rule” is the standard initial treatment for mild hypoglycemia: give 15 grams of fast-acting carbohydrate, wait 15 minutes, and then recheck blood glucose. This intervention rapidly raises blood sugar, relieves symptoms, and prevents progression to severe hypoglycemia. Examples include 4–6 ounces of fruit juice, regular soda, or glucose tablets. This is the priority nursing action.

Rationale:

A. Baclofen is a centrally acting skeletal muscle relaxant that targets the GABA-B receptors in the spinal cord, inhibiting excitatory neurotransmission. By reducing the frequency and severity of muscle spasms, stiffness, and hypertonicity, it helps improve mobility, ADLs, and overall comfort in patients with MS. This demonstrates correct understanding of the therapeutic purpose of the medication.

B. Both baclofen and alcohol are CNS depressants, which can lead to additive effects such as excessive drowsiness, dizziness, hypotension, or impaired coordination, increasing the risk of falls or accidents. Avoiding alcohol ensures patient safety, especially during initiation or dose adjustments.

C. Stopping baclofen abruptly is dangerous. Sudden discontinuation can cause rebound spasticity, severe muscle rigidity, hallucinations, seizures, fever, and even life-threatening complications. Safe discontinuation requires a gradual tapering schedule under medical supervision. This statement indicates the patient does not understand the importance of safe medication management and the physiologic consequences of sudden withdrawal.

D. Drowsiness, fatigue, and generalized weakness are common CNS-related adverse effects of baclofen, particularly at the start of therapy or after dose increases. Educating patients about these effects helps them anticipate changes, avoid risky activities (e.g., driving or operating machinery), and adhere to the regimen while monitoring tolerance.