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Question

Difficulty: EasyPhysiological Adaptation

A client with type 1 diabetes mellitus begins to experience diaphoresis, palpitations, and hand tremors. The client is alert and oriented. In what order should the practical nurse implement the following interventions? Arrange the actions in the correct sequence from first to last.

  1. 1Obtain a fingerstick blood glucose reading.
  2. 2Administer 4 ounces of a fast-acting carbohydrate, such as apple juice.
  3. 3Recheck the blood glucose level after 15 minutes.
  4. 4Provide a snack containing a complex carbohydrate and protein.

Answer

The correct sequence is to first assess the blood glucose, treat with a fast-acting carbohydrate, recheck in 15 minutes, and finally provide a stabilizing snack.
When a conscious client exhibits signs of hypoglycemia, the practical nurse should follow the 'Rule of 15'. The sequence begins with assessment (checking blood glucose), followed by immediate treatment (giving a fast-acting carbohydrate), evaluation of the intervention (rechecking the glucose in 15 minutes), and long-term stabilization (providing a complex carbohydrate and protein snack).

Step-by-Step Solution

1
Obtain a fingerstick blood glucose reading.
The nurse confirms the presence of hypoglycemia.
Assessment is always the priority when a client exhibits new symptoms, ensuring the correct problem is treated.
2
Administer 4 ounces of a fast-acting carbohydrate.
The client's blood sugar begins to rise rapidly.
Simple carbohydrates are quickly absorbed to resolve the acute hypoglycemic state.
3
Recheck the blood glucose level after 15 minutes.
The nurse verifies if the initial treatment was effective.
Continuous evaluation is necessary to determine if further simple carbohydrates are needed, following the standard 'Rule of 15'.
4
Provide a snack containing a complex carbohydrate and protein.
The client's blood sugar remains stable over time.
Complex carbohydrates and proteins digest slowly, preventing a secondary crash in blood sugar.

Key Concept

Management of Acute Hypoglycemia (Rule of 15)
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Topics

Physiological Adaptation

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