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NCLEX · General

A client with type 1 diabetes is found to be diaphoretic, shaky, and confused with a blood glucose of 55 mg/dL. What is the priority intervention?

Correct answer

Give a fast-acting carbohydrate (such as 15 g of glucose, juice, or glucose tablets)

  1. A Administer insulin
  2. B Give a fast-acting carbohydrate (such as 15 g of glucose, juice, or glucose tablets)
  3. C Encourage the client to exercise
  4. D Withhold all food

Why this is the answer

This client has HYPOGLYCEMIA (blood glucose below 70 mg/dL with symptoms: diaphoresis, shakiness, confusion, tachycardia, hunger). The priority is to give a FAST-ACTING CARBOHYDRATE — about 15 grams (4 oz juice, glucose tablets, regular soda, or hard candy) if the client is CONSCIOUS and able to swallow. NCLEX physiological/endocrine. THE '15-15 RULE': give 15 g of carbs, wait 15 minutes, recheck glucose; repeat if still low. If the client is UNCONSCIOUS or unable to swallow, give IV dextrose (D50) or IM/subcutaneous glucagon. NEVER give insulin (would worsen hypoglycemia). Hypoglycemia is an emergency — the brain needs glucose. Treating hypoglycemia with fast-acting carbs is a critical, heavily tested NCLEX concept.
Source: NCLEX Physiological — Hypoglycemia Management

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