NCLEX-RNPharmacological and Parenteral TherapiesEasy
A client with type 1 diabetes reports feeling shaky, sweaty, and confused 45 minutes after receiving regular insulin. Fingerstick glucose is 58 mg/dL and the client is alert enough to swallow. Which action should the nurse take first?
- AAdminister IM glucagon immediately
- BGive the client's next scheduled dose of long-acting insulin
- CAdminister 15 g of a fast-acting carbohydrate such as 4 oz of juice
- DCall the primary provider to report the low glucose
Show answer & explanationAnswer & explanation
Correct answer: C. Administer 15 g of a fast-acting carbohydrate such as 4 oz of juice
For a conscious client with mild-to-moderate hypoglycemia who can swallow safely, the priority is to give 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes (the 'rule of 15'). Glucagon is reserved for unconscious or unable-to-swallow clients.
Why the other options are wrong
- A. Glucagon IM is reserved for clients who are unconscious or cannot swallow.
- B. Insulin would further lower glucose and is contraindicated during hypoglycemia.
- D. Notification can occur after treating the immediate low glucose.
Rule of 15 for Hypoglycemia
For conscious clients with blood glucose <70 mg/dL, give 15 g fast-acting carbohydrate, recheck glucose in 15 minutes, and repeat if still low.
- 15 g carb = 4 oz juice, 3-4 glucose tablets, or 1 tbsp honey
- Recheck glucose 15 min after treatment
- Glucagon IM/IN reserved for unconscious clients
Memory trick: '15-15-15': 15 g carb, wait 15 min, check again