A client who received rapid-acting insulin but ate only a few bites of breakfast is awake, diaphoretic, and shaky. The bedside glucose is 58 mg/dL, and the client can swallow safely. For each group, select all responses that apply.
Multiple Response Grouping
Choose your responses, then check the answer.
Explanation
A glucose of 58 mg/dL with sweating, shaking, and cognitive change is hypoglycemia. Because the client is awake and can swallow, use the 15-15 rule: give 15 g of fast carbohydrate and recheck in 15 minutes.
Findings: diaphoresis/tremor and cognitive change. Actions: 15 g fast carbohydrate and a glucose recheck in 15 minutes.
Why this is the best response
The measured value is below 70 mg/dL and the client can safely take oral carbohydrate, so the 15-15 rule applies.
Why the alternatives do not fit
Polyuria and gradual thirst fit hyperglycemia better. Chocolate has fat that slows sugar absorption, and additional insulin must not precede treatment of the low glucose.
Sources
CDC — Treatment of Low Blood Sugar
CDC — Low Blood Sugar Symptoms
15-15 rule — Give 15 g of carbohydrate and recheck glucose after 15 minutes.
Fast-acting carbohydrate — A glucose source that is absorbed quickly; high-fat foods act more slowly.