What the nurse should give
Her capillary glucose is 58 mg/dL (3.2 mmol/L), and she is awake, alert, and able to swallow, so oral treatment is appropriate. Because she takes acarbose, which blocks the breakdown of sucrose and starch in the gut, the carbohydrate must be glucose itself. At 4 g per tablet, 15 ÷ 4 = 3.75, so four glucose tablets (16 g) are the fewest whole units that reach at least 15 g.
The Rule of 15 and the acarbose exception
The Rule of 15 guides treatment of mild to moderate hypoglycemia in a client who can swallow: give 15 g of fast-acting carbohydrate, recheck glucose in 15 minutes, and repeat if the level remains low. Once glucose recovers, a snack or meal follows to prevent recurrence. Most fast-acting carbohydrates, such as table sugar, juice, or regular soft drinks, contain sucrose or other sugars. Acarbose is an alpha-glucosidase inhibitor; it slows the conversion of sucrose and starch into absorbable glucose, so these sources raise blood glucose too slowly. Pure glucose needs no digestion and is absorbed directly.
| Option | Carbohydrate | Problem |
|---|
| Four glucose tablets | 16 g glucose | Correct: fewest units reaching 15 g; absorbed despite acarbose |
| Two glucose tablets | 8 g glucose | About half the required amount |
| Eight glucose tablets | 32 g glucose | About twice the protocol amount; risks rebound hyperglycemia |
| Four teaspoons of sugar | 16 g sucrose | Enough amount, but acarbose blocks its breakdown |
Why the distractors are wrong
Two tablets provide too little, and the hypoglycemia may persist. Eight tablets overshoot the protocol and may cause rebound hyperglycemia. Four teaspoons of table sugar supply the right amount, but the form is wrong for a client on acarbose, which is the trap in this item.
Nursing application
The nurse gives four glucose tablets, rechecks capillary glucose in 15 minutes, repeats treatment if still low, and offers a snack once glucose has recovered. Because glipizide has a long duration of action, the nurse continues monitoring and reports the episode so her regimen can be reviewed. She is taught to keep glucose tablets or gel, not candy or sugar, for treating lows.
Exam takeaway
Watch out A client on acarbose must treat hypoglycemia with glucose, not sucrose. In dose questions, calculate the fewest whole units that meet the minimum amount.