What is the first line treatment for severe hypoglycemia when a patient is unconscious?
Initiate an insulin infusion
Administer oral glucose tablets
Administer 50% dextrose (D50) injection
Provide glucagon injection
The Correct Answer is C
Rationale:
A. Initiate an insulin infusion: Insulin lowers blood glucose levels and would worsen hypoglycemia. It is contraindicated in this situation and never used as treatment for low blood sugar.
B. Administer oral glucose tablets: Oral glucose is effective only if the patient is awake, alert, and able to swallow safely. An unconscious patient cannot take anything orally due to aspiration risk, making this inappropriate.
C. Administer 50% dextrose (D50) injection: Intravenous dextrose is the first-line treatment for severe hypoglycemia in an unconscious patient because it rapidly restores blood glucose. It works immediately and is the safest and most effective emergency intervention.
D. Provide glucagon injection: Glucagon can be used when IV access is unavailable, as it stimulates glycogenolysis in the liver. However, its effect is slower compared to IV dextrose, which is why glucagon is considered a secondary option rather than the first-line treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Increased serum bicarbonate level: In diabetic ketoacidosis, bicarbonate levels are decreased because bicarbonate is consumed as it buffers the excess ketone acids. An increased bicarbonate level would not be consistent with DKA.
B. Decreased blood pH: The accumulation of ketone bodies in DKA leads to metabolic acidosis. A decreased blood pH, typically below 7.35, is one of the most definitive laboratory findings indicating diabetic ketoacidosis.
C. Elevated blood glucose level: Hyperglycemia is present in DKA, often exceeding 250 mg/dL. However, elevated glucose alone is not specific to DKA since it also occurs in hyperosmolar hyperglycemic state (HHS). The distinguishing factor in DKA is acidosis.
D. Elevated blood urea nitrogen (BUN) level: Increased BUN may occur in DKA due to dehydration and reduced renal perfusion. While it supports the diagnosis, it is not the most specific indicator of DKA compared with blood pH changes.
Correct Answer is B
Explanation
Rationale:
A. Wear compression stockings daily: Compression stockings are helpful for venous insufficiency or preventing deep vein thrombosis, but they do not prevent complications such as retinopathy and nephropathy, which are directly related to vascular changes
B. Maintain stable blood glucose levels: Chronic hyperglycemia damages small blood vessels, leading to microvascular complications including retinopathy and nephropathy. Maintaining stable blood glucose levels slows disease progression and is the most effective preventive strategy.
C. Have an eye examination once per year: Annual eye exams are important for early detection of diabetic retinopathy but do not directly prevent its development. Preventive measures must focus on glucose control to minimize vascular injury before it occurs.
D. Examine your feet carefully every day: Daily foot inspection is essential for preventing peripheral neuropathy complications such as ulcers and infections. However, this practice is not directly related to preventing retinopathy or nephropathy.
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