Question

A nurse is teaching a client who has type 1 diabetes mellitus about actions to take when having manifestations of hypoglycemia with a glucometer reading between 40 and 60 mg/dL. Which of the following instructions should the nurse include?

A: Self-administer 1 mg of glucagon subcutaneously.
B: Self-administer 20 units of regular insulin.
C: Drink 120 mL (4 oz) of skim milk.
D: Drink 120 mL (4 oz) of fruit juice.

Answer 1

In cases of hypoglycemia with glucometer readings between 40 and 60 mg/dL in a patient with type 1 diabetes mellitus, the nurse should advise drinking 120 mL (4 oz) of fruit juice or skim milk rather than administering glucagon or insulin.

Step-by-step explanation:

The instructions a nurse should include when educating a client with type 1 diabetes mellitus experiencing hypoglycemia with a glucometer reading between 40 and 60 mg/dL are related to quick interventions to raise blood glucose levels. The correct action to take in this scenario is most commonly the ingestion of a fast-acting source of sugar. Therefore, the nurse should instruct the client to drink 120 mL (4 oz) of fruit juice or skim milk. This advice is based on understanding the body's need for immediate glucose, which is the brain's primary energy source, and to avoid the risk of a hypoglycemic episode leading to more severe symptoms such as convulsions or coma.

Administering glucagon or additional insulin is not appropriate in cases of hypoglycemia. Glucagon injections are typically reserved for more severe cases where a patient is unable to orally consume carbohydrates, and additional insulin would further lower blood glucose levels, exacerbating the hypoglycemic state.

Answer 2

Choose skim milk for a quick and sustained blood sugar increase (12g carbs); monitor levels and follow with a balanced meal or snack for stability.

Therefore the correct option is C.

Step-by-step explanation:

The appropriate action for the client experiencing hypoglycemia with a glucometer reading between 40 and 60 mg/dL is to choose a rapid-acting carbohydrate source for quick blood sugar elevation. Skim milk is an ideal choice as it contains both simple and complex carbohydrates. The lactose in milk provides a quick boost in blood sugar, while the protein and fat content offer sustained energy, preventing a rapid drop in blood glucose levels after the initial increase. This combination helps in preventing rebound hypoglycemia.

Drinking 120 mL (4 oz) of skim milk provides approximately 12 grams of carbohydrates. Carbohydrates are the primary macronutrient responsible for raising blood glucose levels. In a hypoglycemic state, the goal is to consume about 15 grams of carbohydrates to see a rapid increase in blood sugar levels. The nurse may recommend pairing the milk with a small carbohydrate snack if needed.

The client should monitor their blood glucose levels after consuming the milk and follow up with a balanced meal or snack to maintain stable blood sugar levels. It's crucial for individuals with diabetes to have a personalized plan in place for managing hypoglycemia, and the nurse should encourage ongoing communication with healthcare providers for adjustments as needed.

Therefore the correct option is C.