What is the initial action a nurse should take for a client with type 1 diabetes who presents with severe hypoglycemia?

In the case of a client with type 1 diabetes experiencing severe hypoglycemia, the most immediate and effective action is to administer a rapid source of glucose, which is most efficiently delivered intravenously when the client is unable to consume oral glucose due to altered consciousness or severe hypoglycemic symptoms. Administering 50% dextrose in water via IV push provides a quick and concentrated source of glucose to rapidly increase blood sugar levels, addressing the critical need for immediate intervention in severe hypoglycemia.

Other options have their roles in hypoglycemia management but are not appropriate initial actions in this scenario. For example, assisting the client to drink orange juice is a valid treatment for mild to moderate hypoglycemia but may not be safe or effective if the client is severely hypoglycemic and at risk for swallowing difficulties or unconsciousness. Measuring vital signs, while important in overall patient assessment, does not address the urgent need for glucose. Observing for symptoms like sweating, shakiness, and pallor is useful for diagnosis but does not contribute to the immediate treatment required in severe cases. Thus, when faced with severe hypoglycemia, swift intervention with IV dextrose is the correct approach.