The nurse enters the client's room and finds the client unconscious without intravenous access. The client's blood glucose is 20 mg/dL. Which medication would the nurse administer first?

A. Glucose tabs orally: Oral glucose is only appropriate for a conscious client who can safely swallow. Giving glucose orally to an unconscious client increases the risk of aspiration and airway obstruction. B. Rapid-acting insulin: Insulin would further decrease blood glucose, worsening the hypoglycemia. In a client with a glucose level of 20 mg/dL, insulin administration is contraindicated. C. Dextrose intravenous: IV dextrose is the most effective treatment for severe hypoglycemia, but it requires established IV access. Since the client has no IV line, this option cannot be used immediately. D. Glucagon intramuscularly: IM glucagon is the drug of choice when severe hypoglycemia occurs in an unconscious client without IV access. It rapidly stimulates hepatic glycogen breakdown into glucose, raising blood sugar until IV access can be established for dextrose administration.