The Patient has a nutritional dose of Humalog insulin of 5 units before each meal, plus Humalog insulin per sliding scale.
Blood Glucose Level sliding scale
(mg per dL) Humalog Insulin
If less than 70 and symptomatic administer 1 mg Glucagon IM then call MD 150-200 2 units
201-250 4 units
251-300 6 units
301-350 8 units
351-40010 units
Greater than 400 Call MD
The patient’s meal has been delivered. the nurse checks the patient’s pre-meal blood sugar, and the result is 64 mg/dL.
The patient is awake, and alert. and able to swallow. The next step the nurse should take is:
A.
Call the MD.
B.
Administer 1 mg Glucagon IM.
C.
Administer 5 units of Humalog insulin.
D.
Encourage the patient to eat their meal.
The correct answer and Explanation is :
The correct answer is D. Encourage the patient to eat their meal.
Explanation:
When a patient’s blood glucose level is measured at 64 mg/dL, it indicates hypoglycemia, especially if the patient is symptomatic or has a level below the normal range. In this case, the patient is awake, alert, and able to swallow, which influences the appropriate intervention.
- Assessment of the Situation:
- Blood Glucose Level: 64 mg/dL, which is below the normal range and suggests hypoglycemia.
- Patient Condition: The patient is alert and able to swallow, which is crucial for deciding the intervention.
- Available Options:
- A. Call the MD: This would be necessary if the patient were unable to eat or if the hypoglycemia were severe or symptomatic in a way that required medical intervention beyond immediate corrective actions.
- B. Administer 1 mg Glucagon IM: Glucagon is used in cases of severe hypoglycemia where the patient is unconscious or unable to swallow. In this case, the patient is able to eat and swallow, so glucagon is not appropriate.
- C. Administer 5 units of Humalog insulin: This option is incorrect as Humalog insulin is used to lower high blood glucose levels, not to address hypoglycemia.
- D. Encourage the patient to eat their meal: This is the correct approach for mild hypoglycemia when the patient can safely consume food. Eating the meal will help to raise the blood glucose levels back to a normal range.
Conclusion:
Encouraging the patient to eat their meal is the most appropriate action for addressing a blood glucose level of 64 mg/dL in a patient who is able to eat and swallow. The meal should help to normalize the blood sugar levels gradually. If the patient were symptomatic or unable to eat, alternative measures like glucagon or calling the MD would be necessary.