A nurse observes mild hand tremors in a client who has diabetes mellitus. Which of the following actions should the nurse take after obtaining a glucose meter reading of 60 mg/dL (70-100 mg/dL)?

Choice A rationale Glucagon is a hormone that triggers the liver to release stored glucose into the bloodstream. It is indicated for severe hypoglycemia, typically when the patient is unconscious, seizing, or otherwise unable to safely swallow. Because this client is conscious and demonstrating only mild tremors with a blood glucose of 60 mg/dL, which is below the normal 70-100 mg/dL range, more invasive treatments like intramuscular injections are not the first-line intervention according to standard protocols. Choice B rationale The standard treatment for mild to moderate hypoglycemia, defined here as 60 mg/dL, is the 15-15 rule. This involves consuming 15 grams of fast-acting carbohydrates, such as four ounces of juice or glucose tabs. This amount is sufficient to raise the blood glucose level back into the normal range of 70 to 100 mg/dL without causing excessive hyperglycemia. Since the client is conscious and showing only mild symptoms, the oral route is the safest and most effective choice. Choice C rationale While retesting the blood glucose level is part of the 15-15 rule, it must occur after the intervention has been performed. Delaying treatment to simply perform another test while the patient is symptomatic and has a confirmed low reading of 60 mg/dL is unsafe. Hypoglycemia can progress rapidly to neuroglycopenia, leading to confusion or loss of consciousness. The nurse must act immediately to provide a carbohydrate source to stabilize the patient's blood sugar levels first. Choice D rationale Intravenous dextrose, usually as D50W, is a concentrated sugar solution used for emergency treatment of severe hypoglycemia. It is reserved for patients who are unresponsive or cannot take anything by mouth. A blood glucose of 60 mg/dL is low but generally manageable through oral means if the patient is alert. Using an IV route for a patient who is currently stable and able to swallow is unnecessarily invasive and carries risks such as vein irritation or rebound hyperglycemia.