Ten hours after the client with 50% burns is admitted, her blood glucose level is 90 mg/dL. What is the nurse's best action?
A. Notify the emergency team.
B. Document the finding as the only action.
C. Ask the client if anyone in her family has diabetes mellitus.
D. Slow the intravenous infusion of dextrose 5% in Ringer's lactate.
B
Neural and hormonal compensation to the stress of the burn injury in the emergent phase in-creases liver glucose production and release. An acute rise in the blood glucose level is an ex-pected client response and is helpful in the generation of energy needed for the increased meta-bolism that accompanies this trauma.
You might also like to view...
The nurse is caring for a client in shock, and places the bed at an angle with the head lower than the feet. Which term will the nurse use when documenting this position in the medical record?
1. Reverse Trendelenburg position 2. Trendelenburg position 3. Fowler's position 4. Semi-Fowler's position
What does the nurse expect will occur in a patient as a result of decreased fluid intake? (Select all that apply.)
a. Fluid will be withdrawn from the stool b. The stool becomes hard and dry c. Less mucus is formed in the colon d. Lumen of bowel constricts because of smaller bulk e. Peristalsis slows
A student nurse asks a nurse what items are found within the Strategic National Stockpile (SNS). What is the nurse's best response?
A. Two-way radios B. Prepared meals C. Drinking water D. Antibiotics
A confused patient refuses his medication. What is the nurse's first response?
a. Agrees with the patient's decision and documents it in his chart b. Educates the patient about the importance of the medication c. Discreetly hides the medication in the patient's favorite Jell-O d. Informs the patient that he must take the medication whether he wants to or not