The nurse cares for a client with type 2 diabetes mellitus. The client is alert and oriented but also shaky, pale, and diaphoretic. The client's fingerstick blood glucose is 50 mg/dL (2.8 mmol/L). Which of the following is the best next step the nurse can take?

Question

Quizplus · Accepted Answer

This client is exhibiting signs and symptoms of a hypoglycemic reaction (evidenced by low blood glucose <70 mg/dL [3.9 mmol/L]). The client who is alert enough to ingest food/liquids orally should be given 15 grams of a simple carbohydrate such as orange juice or low-fat milk (Option B). The fat in whole milk slows the absorption process and will not treat hypoglycemia quickly enough. For this reason, low-fat milk is recommended. Fingerstick blood glucose should be checked 10-15 minutes after this (Option D). If the client shows no improvement, the simple carbohydrate can be readministered orally. (Options A and C) Dextrose (D50 IV push), a highly concentrated sugar, and glucagon (intramuscular, subcutaneous, intravenous/gel), a hormone that stimulates glycogenolysis (conversion of glycogen to glucose), are administered to hypoglycemic clients who are unable to ingest a simple oral carbohydrate. These can cause rebound hypoglycemia by stimulating additional insulin release from the body in response to increased serum glucose levels. Educational objective: A client who experiences a hypoglycemic reaction (evidenced by low blood glucose <70 mg/dL [3.9 mmol/L]) and is alert enough to ingest food/liquids orally should be given a simple carbohydrate (eg, orange juice, low-fat milk).

The Nurse Cares for a Client with Type 2 Diabetes