You are treating a patient who is unconscious and unresponsive following administration of home insulin an hour before. The patient is cool, pale, and diaphoretic. The pulse is rapid and thready. Which of the following treatments is MOST likely to be beneficial to the patient?
a. Administration of insulin to stimulate circulating glucose to enter the cells.
b. Administration of large volumes of normal saline to combat the shocklike symptoms.
c. Administration of dextrose 50%.
d. Close monitoring of the patient while allowing the insulin the patient has already used to take effect.
c
Rationale: a. Further administration of insulin would be detrimental to this patient.
b. While the patient is experiencing symptoms of "insulin shock", glucose is most correct to combat the symptoms.
c. Correct.
d. Allowing time to pass would further cause the glucose in the bloodstream to decrease which may result in brain death due to lack of glucose.
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