The nurse reviews an older adult receiving insulin glargine. Which action is the priority?
Chart/Exhibit
Choose your responses, then check the answer.
Explanation
Current hypoglycemia and rapidly declining renal function make an unchanged long-acting dose unsafe; treat first and obtain authorized dose reassessment.
Quick answer Treat the glucose of 54 mg/dL, hold the scheduled dose, and request renal-aware basal-dose review.
Why this is correct Insulin glargine can cause prolonged hypoglycemia, and renal impairment may reduce insulin requirements. The label calls for more frequent glucose monitoring when renal function changes.
Easy analogy or mental picture A long-acting dose is a train already on the track; reduced clearance can make the trip longer, not safer.
NCLEX decision rule Address active hypoglycemia before giving more insulin and match future dosing to the new physiologic state.
Why the other choices are wrong Acute illness does not justify ignoring a measured low glucose, and eating once does not remove the risk from a long-acting dose.
References
1DailyMed: Insulin GlargineHypoglycemia risk and closer monitoring in renal or hepatic impairment