While rounding on a medical unit, the practical nurse (PN) encounters a conscious client with a history of diabetes mellitus who is trembling and visibly diaphoretic. Place the following nursing interventions in the correct chronological sequence to appropriately manage this acute situation.
- 1Check the client's capillary blood glucose level.
- 2Administer 15 grams of a simple, fast-acting carbohydrate.
- 3Re-evaluate the capillary blood glucose level in 15 minutes.
- 4Supply the client with a snack containing complex carbohydrates and protein.
Answer
The correct sequence is to verify the blood glucose first, immediately treat with a fast-acting carbohydrate, recheck the glucose in 15 minutes to evaluate effectiveness, and finally provide a sustaining snack once stable.
The standard management for acute hypoglycemia in a conscious client follows the 'rule of 15'. The nurse must first collect data by checking the blood glucose to confirm the condition. Next, the nurse administers 15 grams of a fast-acting carbohydrate (such as juice) to rapidly correct the low blood sugar. The nurse then waits 15 minutes and reassesses the blood glucose to ensure the intervention was effective. Finally, once the blood glucose is in a safe range, providing a snack with complex carbohydrates and protein helps sustain the blood glucose level and prevents it from dropping again.
Step-by-Step Solution
Key Concept
Management of acute hypoglycemia using the 'rule of 15'