Kelly is a 10-year-old type 1 diabetic brought to the school nurses office complaining of feeling "sweaty and shaky" which she recognizes as symptoms of hypoglycemia. The nurse should:
1. Provide 15 grams of glucose and recheck her finger stick in 15 minutes.
2. Provide a large candy bar and send her back to class.
3. Send someone to get a bottle of soda from the vending machine and tell her to drink it until she feels better.
4. Call the ambulance if her finger stick is less than 200.
1
Rationale: Episodes of hypoglycemia should be treated by administering 15 grams of glucose and rechecking finger sticks until stable. A candy bar and soda contain more than 15 grams of glucose, and either could result in a hyperglycemic episode. Finger sticks should be checked every 15 minutes until stable to assess if the correction for the additional carbohydrates is only temporary, and if so additional doses of 15 grams of carbohydrates should be given. A blood sugar of 200 is considered hyper- not hypoglycemia.
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