Which action would be taken by the nurse caring for a client with type 1 diabetes mellitus who has a finger-stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime and a prescription for sliding-scale regular insulin?

Which action would be taken by the nurse caring for a client with type 1 diabetes mellitus who has a finger-stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime and a prescription for sliding-scale regular insulin?

• A. Call the health care provider
• B. Encourage intake of fluids
• C. Administer the insulin as prescribed
• D. Give the client 4 ounces of orange juice

Answer: (C)

A bedtime glucose of 258 mg/dL in someone with type 1 diabetes is addressed by correcting with the prescribed insulin. A sliding-scale dose of regular insulin is specifically intended to bring elevated glucose down toward the target range. Administering the insulin as prescribed directly counteracts the high level and helps prevent nocturnal ketosis; after giving the dose, recheck the glucose according to protocol. Giving orange juice would raise the glucose, and fluids alone won’t correct hyperglycemia. Calling the provider is unnecessary here if a sliding-scale order exists and the protocol is followed, though you would reassess if the glucose remains high after correction or if there are other concerning signs.

A bedtime glucose of 258 mg/dL in someone with type 1 diabetes is addressed by correcting with the prescribed insulin. A sliding-scale dose of regular insulin is specifically intended to bring elevated glucose down toward the target range. Administering the insulin as prescribed directly counteracts the high level and helps prevent nocturnal ketosis; after giving the dose, recheck the glucose according to protocol. Giving orange juice would raise the glucose, and fluids alone won’t correct hyperglycemia. Calling the provider is unnecessary here if a sliding-scale order exists and the protocol is followed, though you would reassess if the glucose remains high after correction or if there are other concerning signs.