Practice Question
A Nurse was attending to a patient
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Rationale:
Condition: Hypoglycemia
📌The client receiving parenteral nutrition (PN) presents with shakiness, headache, sweating, nausea, and weakness, which are classic signs of hypoglycemia.
📌PN solutions are high in dextrose, and abrupt interruption or delayed administration can cause a rapid drop in blood glucose levels, especially if insulin secretion continues after glucose supply is stopped.
📌Additionally, the client is NPO (nothing by mouth), so they lack an oral glucose source to stabilize their blood sugar when PN flow changes.
📌Therefore, the client’s current symptoms are most consistent with hypoglycemia related to PN interruption rather than infection or fluid overload.
💎 Action 1: Check blood glucose level
🔹 First priority: Assess the client’s capillary blood glucose immediately to confirm hypoglycemia.
🔹 This determines the severity and guides subsequent interventions (e.g., whether to give IV dextrose).
🔹 Checking glucose helps differentiate hypoglycemia from other causes of dizziness or weakness, such as infection or dehydration.
🔹 Always check glucose before altering PN rate or calling the provider, as rapid identification prevents neurologic complications.
💎 Action 2: Provide glucose source
🔹 If blood glucose is below 70 mg/dL, the nurse should administer a glucose source immediately — typically IV 10% or 50% dextrose if the client is NPO or on PN.
🔹 This stabilizes blood sugar and relieves acute symptoms like tremors and sweating.
🔹 For PN clients, it’s critical to avoid abrupt discontinuation of the PN infusion. If PN must be paused, hang 10% dextrose (D10W) to prevent rebound hypoglycemia.
🔹 Follow-up includes rechecking glucose after 15 minutes and documenting the response.
💎 Parameter 1: Blood glucose levels
🔹 Frequent monitoring of blood glucose every 4–6 hours (or per protocol) ensures early detection of fluctuations.
🔹 During PN therapy, glucose can swing high or low depending on infusion rate or interruptions.
🔹 The goal is to maintain glucose levels within a safe range (typically 70–140 mg/dL) to avoid metabolic instability.
🔹 Continuous tracking helps in adjusting PN composition and tapering schedules safely.
💎 Parameter 2: Toleration of tapering down in last hour of infusion
🔹 PN infusions should be gradually tapered down over 1–2 hours rather than stopped suddenly.
🔹 Tapering allows the body to adjust insulin secretion and prevents rebound hypoglycemia as dextrose supply decreases.
🔹 During this tapering, monitor for return of hypoglycemic symptoms like sweating, tremors, or confusion.
🔹 Document how the client tolerates tapering and whether additional glucose support is needed.
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This question is from Examplify CJE Pediatrics Benchmark 1 2025 which contains 44 questions.
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Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: 💎Examplify-PN
- Domain: 👩🏻🤝👩🏻Pediatrics-PN
- Answer Choices: 0