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Nursing QUESTION #9312
Question 1
A patient with type 1 diabetes mellitus develops unconsciousness at home. The nurse arriving at the scene suspects hypoglycemia. The safest initial management is:
  • Administer subcutaneous insulin
  • Administer oral glucose (juice or glucose tablets)
  • Administer IV dextrose 50% (D50W)✔️
  • Wait for blood glucose result before acting
Correct Answer Explanation

Management of unconscious hypoglycemic patient:

  • NEVER give anything orally to an unconscious patient — risk of aspiration
  • IV Dextrose 50% (D50W) — 25–50 mL IV push is the immediate treatment for unconscious hypoglycemia
  • If IV access unavailable: Glucagon 1 mg IM/SC (stimulates hepatic glycogenolysis)

For conscious patients: oral glucose (15g fast-acting carbohydrates — 4 glucose tablets, 125 mL juice) → Rule of 15:

\\text{Give 15g carbohydrates} \\rightarrow \\text{Wait 15 min} \\rightarrow \\text{Recheck glucose} \\rightarrow \\text{Repeat if still} < 70 \\text{ mg/dL}

Critical distinction: In this question, the patient is unconscious — oral route is contraindicated. D50W IV is the answer.