What is the immediate management for a patient with 40mg/ dL Random Blood Sugar (RBS) ?

Question

Question

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KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: 50% dextrose

Rationale:

A Random Blood Sugar (RBS) level of 40 mg/dL is critically low and indicates severe hypoglycemia. Hypoglycemia can lead to neurological symptoms such as confusion, seizures, and even coma if not promptly addressed.
50% dextrose is a hypertonic solution containing a concentrated amount of glucose. It is administered intravenously to rapidly elevate blood glucose levels in cases of acute hypoglycemia.
The immediate management of severe hypoglycemia involves providing a rapid source of glucose to prevent further neurological damage and stabilize the patient.

Explanation of Other Options:

5% dextrose

Rationale: 5% dextrose is an isotonic solution that provides a lower concentration of glucose compared to 50% dextrose. It is typically used for maintenance fluid therapy rather than for the acute correction of hypoglycemia. In a critically hypoglycemic patient, its glucose content is insufficient to rapidly restore blood sugar levels.

5% DNS (Dextrose Normal Saline)

Rationale: 5% DNS contains both glucose and saline. While it can provide glucose, the concentration is similar to 5% dextrose, which is inadequate for the immediate management of severe hypoglycemia. It is more commonly used in cases requiring hydration along with mild glucose supplementation.

Ringer Lactate

Rationale: Ringer Lactate is a balanced electrolyte solution used for fluid replacement in cases such as dehydration, shock, or electrolyte imbalances. It does not contain glucose and is not suitable for treating hypoglycemia.

Conclusion:

Severe hypoglycemia is a medical emergency requiring prompt intervention. Among the given options, 50% dextrose is the most appropriate choice for rapidly increasing blood glucose levels and stabilizing the patient. Other solutions either lack sufficient glucose or are intended for hydration and electrolyte replacement rather than acute hypoglycemia management.