An older client taking glipizide is confused and diaphoretic. The blood glucose is 48 mg/dL, and the client can swallow safely. Which action should the nurse take first?
1Administer the next glipizide dose with a high-protein meal to prevent another glucose decrease.
2Give crackers and cheese, then recheck the blood glucose at the next scheduled meal.
3Keep the client NPO and obtain intravenous dextrose because glipizide prevents oral glucose absorption.
4Give 15 g of rapid-acting carbohydrate, recheck in 15 minutes, and repeat treatment if still low.✓ Correct answer
Explanation
A conscious client who can swallow and has symptomatic hypoglycemia should receive 15 g of rapid-acting carbohydrate, followed by a glucose recheck in 15 minutes and repeat treatment if the value remains low. Glipizide can cause severe and recurrent hypoglycemia, especially in older adults, so the dose is held and the provider is notified for continued monitoring and medication review after immediate treatment.
Clinical reasoning Glipizide stimulates insulin release, so hypoglycemia can persist or recur after the first glucose correction. Immediate oral treatment is appropriate only when swallowing is safe.
Decision rule Use the 15-15 approach for a conscious client, then continue surveillance and obtain medication guidance because sulfonylurea-related hypoglycemia may recur.