A diabetic mother has just given birth to a baby boy. The baby appears lethargic and has a high-pitched cry. The initial plasma glucose level was 19 mg/dL. What is the proper nursing action for this infant?
1. Wait 30 minutes and re-test plasma glucose levels.
2. Have the mother breastfeed the infant.
3. Start an IV with D5W dextrose solution.
4. Start an IV with D10W dextrose solution.
Correct Answer: 4
Rationale 1: This infant is suffering from severe hypoglycemia. Aggressive treatment with D10W dextrose by IV is recommended.
Rationale 2: This is an appropriate nursing action if the infant's plasma glucose levels are between 25 and 40 mg/dl. This infant needs more aggressive treatment.
Rationale 3: D5W dextrose is primarily use to either prevent hypoglycemia or titrate down the concentration of administered glucose when the infant is transitioning off the glucose. A higher concentration of glucose is required for severely hypoglycemic infants.
Rationale 4: This is the proper nursing action. Infants with severe hypoglycemia should be aggressively treated with IV infusion of D10W dextrose.
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