Your patient is a 68-year-old female who has been in a rehabilitation hospital for one week following hip replacement surgery. According to the staff, the patient is a type II diabetic and is being treated for a postoperative infection. The patient was lethargic yesterday and was found unresponsive this morning, just before your arrival. Physical exam reveals an accumulation of secretions in her airway, lung sounds clear and equal bilaterally, and skin and mucous membranes warm and dry. HR = 119, BP = 86/58, RR = 16, blood glucose = 864 mg/dL. In addition to initiating basic airway management measures and gaining IV access, which of the following is the best treatment for this patient?
A) Intubate, 1 to 2 L NS bolus, 25 g dextrose IV
B) Oxygen by nonrebreather mask, NS at a KVO rate, 50 mEq sodium bicarbonate IV
C) BVM ventilations with supplemental oxygen, NS at a KVO rate
D) Intubate, 1 to 2 L NS bolus
Answer : D. D) Intubate, 1 to 2 L NS bolus
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