The nurse has administered 4 oz of orange juice to an alert ...

[dmcintosh]

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?
 
  a. Give the patient 4 to 6 oz more orange juice.
  b. Administer the PRN glucagon (Glucagon) 1 mg IM.
  c. Have the patient eat some peanut butter with crackers.
  d. Notify the health care provider about the hypoglycemia.

Question 2

A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit.
 
  Which finding by the nurse is most important to discuss with the health care provider?
  a. Hemoglobin A1C level is 7.9.
  b. Last eye exam was 18 months ago.
  c. Glomerular filtration rate is decreased.
  d. Patient has questions about the prescribed diet.

[Kingjoffery]

Answer to Question 1

ANS: A
The rule of 15 indicates that administration of quickly acting carbohydrates should be done 2 to 3 times for a conscious patient whose glucose remains less than 70 mg/dL before notifying the health care provider. More complex carbohydrates and fats may be used once the glucose has stabilized. Glucagon should be used if the patient's level of consciousness decreases so that oral carbohydrates can no longer be given.

Answer to Question 2

ANS: C
The decrease in renal function may indicate a need to adjust the dose of metformin or change to a different medication. In older patients, the goal for A1C may be higher in order to avoid complications associated with hypoglycemia. The nurse will plan on scheduling the patient for an eye exam and addressing the questions about diet, but the biggest concern is the patient's decreased renal function.

[dmcintosh]

Excellent

[xiaomengxian]

TYSM