A child with newly diagnosed diabetes is in the emergency room and is unconscious. Glucagon has been prescribed for treatment of hypoglycemia. What would be important nursing management?
1. Watch for side effects of hypoglycemia
2. Child usually awakens within 20 minutes of receiving glucagon.
3. Vomiting may occur after administration, so aspiration precautions should be taken.
4. Do not rotate sites for administration, because even absorption in the abdomen is best.
5. Give PO glucagon once the client has consciousness.
6. Monitor blood values for increasing blood sugar.
Rationale: (1, 2, 3, 6)
Glucagon is the medication of choice used to elevate blood sugar levels after insulin overdose. It does not correct hypoglycemia resulting from starvation. Rebound hypoglycemia is a potential adverse effect, which is why it is important for the client to have carbohydrates once consciousness returns. No significant side effects exist. If unconscious when administered, the child usually awakens in 5 to 20 minutes after receiving glucagon. Vomiting may occur after administration, so aspiration precautions should be taken by placing the child on the side. Blood work to monitor an increase in blood sugar (desired outcome) would be collected. IV is the preferred method of glucagon administration, although the medication is able to be given subQ and IM, not PO. When client is conscious, oral carbohydrates and protein should be given. (Lehne, 7 ed., p. 683.)
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