Practice Quiz

CCRN Critical Care Nursing

Category - Adult

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A 77 year old male patient is admitted with confusion, a blood glucose level of 1150 mg/dL, confusion, blood pressure of 88/45, heart rate of 120 and serum sodium of 148 and no urine output for the last 12 hours. What order would the nurse anticipate?
  1. A bolus of Dextrose 5%, Normal Saline 9% over one hour.
  2. A bolus of 10 units of regular insulin, followed by a continuous infusion of 0.1 unit/kg/hour.
  3. Begin a continuous infusion of regular insulin 0.1 unit/kg/hour.
  4. Replenish electrolytes based on the levels of the lab draw.
Explanation
Answer: B - The orders the nurse would anticipate for the patient with Hyperglycemia and Hypovolemia is administer a bolus of insulin followed by a continuous infusion of insulin. In addition, normal saline (not dextrose with normal saline) bolus would be administered to reverse the Hypovolemic state.
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