# A client with type 1 diabetes is awake, can swallow, and reports shakiness. The point-of-care glucose is 52 mg/dL. Which action should the nurse take?

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> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client with type 1 diabetes is awake, can swallow, and reports shakiness. The point-of-care glucose is 52 mg/dL. Which action should the nurse take?

## Option

1. Give 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes. **✔ Correct answer**
2. Administer long-acting insulin and provide a meal tray.
3. Keep the client NPO until the provider evaluates the client.
4. Give glucagon IM as the first intervention.

**Correct answer: 1**

## Explanation

The client has symptomatic hypoglycemia and is awake and able to swallow, so oral rapid-acting carbohydrate is indicated. The 15-15 approach gives 15 g carbohydrate and rechecks glucose after 15 minutes. Glucagon is reserved for severe hypoglycemia when the client cannot safely take oral carbohydrate.

## In-depth explanation

Clinical Judgment
Airway and swallowing are intact, so use oral fast carbohydrate before parenteral rescue medication.

Memory Tip
Awake and swallow: 15 g now, recheck in 15 minutes.

KR vs US
NCLEX commonly tests the route decision: oral carbohydrate for conscious clients, glucagon for severe or unsafe swallowing.

## Clinical scenario

Clinical Practice Guide
CDC low blood sugar guidance describes the 15-15 rule: take 15 grams of carbohydrate, wait 15 minutes, and check glucose again.

Caution
Avoid overtreatment with high-fat foods because absorption can be delayed.

## Key concepts

- **Hypoglycemia** — Low blood glucose that may cause shakiness, sweating, confusion, tachycardia, or seizure if untreated.
- **Oral Glucose** — Fast-acting carbohydrate given by mouth when the client is alert and can swallow safely.
- **Rule of 15** — A common low glucose response: 15 g carbohydrate, wait 15 minutes, and recheck glucose.

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