by victorsunshine

I ran across one question, the patient's blood glucose is 68, what shall you do? do you still admister the insulin or give simple sugar? the correct answer is give insulin, why? isn't the patient already hypoglycemic?

Re: blood glucose 68, still need insulin?

Originally Posted by victorsunshine

I ran across one question, the patient's blood glucose is 68, what shall you do? do you still admister the insulin or give simple sugar? the correct answer is give insulin, why? isn't the patient already hypoglycemic?

It is hard to answer this question without the full question. However, if you give insulin to a person who has a BS of 68 then they will become hypoglycemic, of course it also depends on how much insulin you are giving.

I would have answered the question by giving simple complex carbohydrates, milk, juice, etc.

Re: blood glucose 68, still need insulin?

I also think it depends on type of Insulin as some are short acting and others are long acting.

Re: blood glucose 68, still need insulin?

Need to know what kind of insulin if it is Lantus than yes you give it.

Re: blood glucose 68, still need insulin?

Originally Posted by victorsunshine

I ran across one question, the patient's blood glucose is 68, what shall you do? do you still admister the insulin or give simple sugar? the correct answer is give insulin, why? isn't the patient already hypoglycemic?

I would have answered the question the same way as the other student give the patient something to and drink. Was that on a test or out of a book?

Re: blood glucose 68, still need insulin?

Originally Posted by victorsunshine

I ran across one question, the patient's blood glucose is 68, what shall you do? do you still admister the insulin or give simple sugar? the correct answer is give insulin, why? isn't the patient already hypoglycemic?

got this question from Kaplan, pt has regular insulin, blood glucose is 68, and pt is nauseated. the rationale is if you give Orange juice, pt will vomit. "blood glucose increases during illness even though patient cannot eat, admister insulin." Why?

Re: blood glucose 68, still need insulin?

With our kids with diabetes in school, we correct the low glucose (one was 38 the other day!!) with juice/glucose tabs then if it is right before lunch, the student gives themselves insulin according to the carbs they are about to eat-these are kids that take humalog before meals. So I guess the answer for what we do is-BOTH. That's why I hate test questions.

Re: blood glucose 68, still need insulin?

Your bodies natural response to illness is to make more sugar.Often this will mean you will need to take a higher dose of insulin than usual,rather than cutting the dose or not taking it.Reducing or not taking it can lead to serious problems such as diabetic ketoacidosis.

Re: blood glucose 68, still need insulin?

This is the reason why I don't like nclex test questions.

We have 4-5 different answers here explaining why this is is wrong or right.

Re: blood glucose 68, still need insulin?

This is the reason why we are not supposed to overthink with every question in the NCLEX. The question only asked if we are to give insulin to the patient...of course we should! DM patients especially type I, needs to have insulin most especially during stressful situations...and remember that they easily rebound from once hypoglycemic state to hyperglycemia which is why close monitoring is key...it all depends on the type of insulin. in this case, regular insulin may be contraindicated...this is just my take on the topic