Question

The following are are two scenarios for adults and neonates related to managing hypoglycemic patients.

Your patient is an insulin dependent diabetic who took a regular dose of insulin 1 hour and 30 minutes ago. She intended to stop at a fast food restaurant and eat breakfast but had a flat tire. This caused her to be delayed. She apparently drove her car at low speed into a shallow drainage ditch alongside of the road where she was found by a bystander who called 911. Police are on the scene, and it is safe. You see that she is wearing a diabetic bracelet, check her blood sugar level and find that it is 36 mg/dL. She responds to voice commands with slurred speech. She does not know where she is, where she has come from, nor where she is going. Discuss the following. Administration of 50% glucose in oral jell. Would you or would you not choose this form of glucose for this patient? Why? Describe how to administer oral glucose jell to a patient. You have premixed syringes of 50% glucose in water (D50W), each containing 25 grams of glucose in 50 mL of solution. You decide to administer 12.5 grams of glucose. How many mL of this solution will you give? After receiving 12.5 grams of D50W, your patient is now able to answer your questions appropriately, but her blood glucose level remains at 50 mg/L. What should you do? Your service does not carry D50W. Instead it carries 500 mL bags of D5W. In order to administer 12.5 grams of glucose from a 500 mL bag of D5W, how many mL will you administer? To give 12.5 grams of glucose from a 500 mL bag of D5W over 10 minutes, using a 10 gtt administration set, how many gtt/min will you administer? A neonate is hypoglycemic and must receive D10W. You have prefilled syringes of D50W on hand. Explain how to make a D10W solution from a D50W prefilled syringe.

Answer 1

#. I will give oral glucose. It is a sugar gel that can be administered in diabetic emergency.

Three conditions must be met in order for oral glucose to be administered. They are:

1.The patient has an altered mental status.

2.The patient has a history of diabetes controlled by medications.

3.The patient has the ability to swallow.

#. 25 grams of glucose in 50 mL of solution.

We have to administer 12.5 grams of glucose

Using unitary method :-

25 grams of glucose in 50 mL of solution. decide Then 12.5 grams of glucose will be in 25ml of solution .

So,25ml of solution will be administered.

#. To give 12.5 grams of glucose from a 500 mL bag of D5W over 10 minutes, using a 10 gtt administration set, how many gtt/min will you administer

Flow rate = total volume / total time × drop factor

= 500ml/10min× 10gtt/ml

= 500gtt/min

#.