MEDizzy - A client’s problem with ineffective control of type 1

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Comprehensive Nursing Test

A client’s problem with ineffective control of type 1 diabetes is identified when a sudden decrease in blood glucose level is followed by rebound hyperglycemia. What should the nurse do when this event occurs?

ExplanationD. The client is experiencing the Somogyi effect. It is a paradoxical situation in which sudden decreases in blood glucose are followed by rebound hyperglycemia. The body responds to the hypoglycemia by secreting glucagon, epinephrine, growth hormone, and cortisol to counteract the low blood sugar. This results in an excessive increase in the blood glucose level. It most often occurs in response to hypoglycemia when asleep. The health care provider may choose to decrease the insulin dose and then reassess the client. A. This will further increase the serum glucose level and is contraindicated. B. Increasing the insulin dose at bedtime will further worsen the problem. C. This will not address the hypoglycemia and rebound hyperglycemia that occurs when sleeping. However, a bedtime snack may help minimize this event.