8. One hour after starting the insulin drip at 10 units/hr, the client's blood sugar has fallen from 899 to 750. Which action should a nurse take?
8. One hour after starting the insulin drip at 10 units/hr, the client's blood sugar has fallen from 899 to 750. Which action should a nurse take?
. Increase the insulin drip rate to 20 units/hr.
. Decrease the insulin drip rate to 7 units/hr.
. Give a bolus of 10 units of regular insulin and increase the drip rate to 8 units/hr.
. Keep the rate the same and do not bolus.
Test-Taking Tip
Recognize a therapeutic drop in blood glucose versus a change that will potentially cause a problem.
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Implementation; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Adverse Effects/Contraindications/Interactions
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Answer 1 is incorrect because rapid reduction in blood glucose reduces serum osmolarity and may shift fluids into cells, causing cerebral edema. The blood glucose level should not fall by more than 15% an hour. The insulin infusion rate should be reduced, not increased. Answer 2 is correct because rapid reduction in blood glucose reduces serum osmolarity and may shift fluids into cells, causing cerebral edema. The blood glucose should not fall by more than 15% an hour. Slow the insulin infusion rate. Answer 3 is incorrect because rapid reduction in blood glucose reduces serum osmolarity and may shift fluids into cells, causing cerebral edema. The blood glucose level has fallen by more than 15% an hour. The insulin infusion rate is too fast and no bolus is needed. Answer 4 is incorrect because blood glucose level has dropped by more than 15% in 1 hour. This reduces serum osmolarity and may shift fluids into cells, causing cerebral edema. The insulin infusion rate should be reduced.