Insulin Hypoglycemia
A 55-year-old client with type 2 diabetes received the morning insulin dose but skipped breakfast before a scheduled test. Before lunch the client calls the nurse feeling shaky.
Recognize cues
Vital signs: BP 138/82, HR 112, RR 20, SpO2 98%, temperature 36.8 C. The client is diaphoretic, tremulous and confused about the time of day. Point-of-care glucose is 44 mg/dL. The client can swallow and follow simple directions.
Which finding requires the most immediate follow-up?
Take action
The unit hypoglycemia protocol allows oral carbohydrate for clients who can swallow, IV dextrose or glucagon for those who cannot, and a recheck in 15 minutes.
Which two actions should the nurse take first?
Evaluate outcomes
Fifteen minutes later the glucose is 96 mg/dL. The client is alert, oriented and no longer diaphoretic, and eats a lunch tray with protein and carbohydrate. HR 84.
Which finding best indicates the treatment is working?
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