Question

A patient with long-standing type 1 diabetes presents to the emergency department with a loss of consciousness and seizure activity. The patient has a history of renal insufficiency, gastroparesis, and peripheral diabetic neuropathy. Emergency personnel reported a blood glucose of 32 mg/dL on scene. When providing discharge teaching for this patient and family, the nurse instructs on the need to do which of the following? (Select all that apply.)

a. Administer glucagon 1 mg intramuscularly any time the blood glucose is less than 70 mg/dL.
b. Administer 15 grams of carbohydrate orally for severe episodes of hypoglycemia.
c. Discontinue the insulin pump by removing the infusion set catheter.
d. Increase home blood glucose monitoring and report patterns of hypoglycemia to the provider.
e. Perform blood glucose monitoring before exercising and driving.

Answer 1

Upon discharge, the patient with type 1 diabetes and hypoglycemia should be instructed to use glucagon for lows below 70 mg/dL, increase blood glucose monitoring, report hypoglycemia to their provider, and check blood glucose before exercising and driving.

Step-by-step explanation:

A patient with long-standing type 1 diabetes, experiencing loss of consciousness and seizure due to hypoglycemia, should be instructed on several key points upon discharge. The nurse should emphasize the following:

• Administer glucagon 1 mg intramuscularly if the blood glucose is less than 70 mg/dL to quickly raise blood sugar levels.
• For severe episodes of hypoglycemia, 15 grams of carbohydrate should be consumed orally when the individual is conscious and able to swallow, not during unconsciousness or seizures.
• Increase home blood glucose monitoring and share any patterns of hypoglycemia with their healthcare provider to adjust insulin therapy if necessary.
• Always perform blood glucose monitoring before activities that require full attention, such as exercising and driving, to ensure safety.

The above instructions are vital to managing blood sugar levels effectively and preventing further hypoglycemic events.