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A nurse is assessing a client who is lethargic, diaphoretic, and difficult to arouse. The client's blood sugar result was 40 mg/dL. The nurse anticipates which of the following to be administered?

A.

Glucose tablets

B.

Epinephrine

C.

IVP dextrose 50%

D.

4 oz of orange juice

Answer and Explanation

The Correct Answer is C

A. Glucose tablets are appropriate for clients with mild hypoglycemia who are alert and able to chew and swallow; they are not suitable for someone who is difficult to arouse.  

 

B. Epinephrine is not used as a treatment for hypoglycemia; it does not directly increase blood glucose levels.  

 

C. IVP (intravenous push) dextrose 50% is indicated for severe hypoglycemia in clients who are lethargic or unresponsive, as it rapidly increases blood glucose levels. 

 

D. Orange juice is effective for mild hypoglycemia but is not appropriate in this case due to the client’s altered mental status and risk of aspiration.


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Correct Answer is D

Explanation

A. Hydralazine is a vasodilator that does not directly replace ACE inhibitors and is not the preferred alternative for managing hypertension or heart failure.

B. Metoprolol is a beta-blocker that is used for different indications and is not a direct substitute for ACE inhibitors.

C. Furosemide is a loop diuretic used for fluid management, not as an alternative to ACE inhibitors.

D. Losartan is an angiotensin II receptor blocker (ARB) and serves as a suitable alternative to ACE inhibitors for patients who experience a cough from them, as ARBs do not typically cause this side effect.

Correct Answer is A

Explanation

A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.

B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.

C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.

D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.

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