# 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.

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> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

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.

Findings consistent with the current glucose problem

Diaphoresis and tremor

New irritability and difficulty concentrating

Polyuria developing over several days

Warm dry skin with gradual thirst

Immediate nursing actions for this awake client

Give 15 g of a fast-acting carbohydrate

Recheck the glucose in 15 minutes

Give chocolate as the first treatment because it contains sugar

Administer the scheduled long-acting insulin before treating the low value

## 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.

## In-depth explanation

Quick answer
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

## Key concepts

- **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.

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