The patient's meal has been delivered, and the nurse checks the patient's pre-meal blood sugar.
The result is 50 mg/dL. The patient is clammy, diaphoretic, and non-arousable.
The next step the nurse should take is:
Administer 1 mg Glucagon IM.
Administer 25 g of dextrose IVP.
Hold the insulin and encourage the patient to eat their meal.
Administer 7 units of Humalog insulin.
The Correct Answer is B
Choice A rationale
Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency.
Choice B rationale
Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction.
Choice C rationale
Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient’s condition.
Choice D rationale
Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency.
Choice B rationale
Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction.
Choice C rationale
Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient’s condition.
Choice D rationale
Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Correct Answer is A
Explanation
Choice A rationale
Insulin lispro (Humalog) is a rapid-acting insulin that begins to lower blood glucose within 15 minutes of injection, with a peak effect occurring in 30 minutes to 1 hour. It mimics the insulin release following a meal, allowing for better postprandial glucose control.
Choice B rationale
Intermediate-acting insulin, such as NPH, has an onset of 1.5 to 4 hours and provides blood glucose control over an extended period. Insulin lispro does not fit this profile, as it acts quickly and is used for meal-time glucose management.
Choice C rationale
Long-acting insulins, such as glargine or detemir, have no peak and provide basal glucose control for 24 hours or more. Lispro is not suitable for basal control due to its rapid action and short duration.
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