The client's blood glucose level is 134 mg/dL at 7 AM and 71 mg/dL at 3 PM. Which should the nurse implement first?
1. Assess the client for confirmatory findings.
2. Check calibration of the blood glucose meter.
3. Administer insulin according to a sliding scale.
4. Instruct client to have orange juice and crackers.
1
1. As long as the client is not in acute distress, the nurse assesses the client for hy-poglycemia to determine whether the client presentation matches the glucose results. If the nurse determines that the client has clinical indicators of hypoglycemia, a repeat blood test is potentially avoided. The nurse knows the client is in acute distress after performing a nursing assessment in an emergency aptly; the nurse incorporates emergency findings with the low glucose level to plan suitable nursing interventions.
2. Checking the calibration of the device is reasonable intervention.
3. Insulin drives glucose into the cells, further decreasing blood sugar.
4. The client is hypoglycemic and needs supplemental calories to elevate the blood sugar to the normal range, so the nurse provides a carbohydrate snack to increase the blood sugar quickly and a complex carbohydrate snack to sustain the blood sugar. The nurse follows agency policy about repeat blood sugar measurement when the client's result is out of normal limits. If permitted by agency policy, the client can benefit from another measurement to verify hypoglycemia. If the client had critical hypoglycemia, the nurse potentially needs to repeat the fingerstick test, withdraw blood for a serum blood sugar level, and administer IV glucose or glucagon.
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