If a patient presents with greater than 300 BGL, what should be administered as initial treatment?

In the scenario where a patient presents with a blood glucose level (BGL) greater than 300 mg/dL, the initial treatment should focus on fluid replacement and management of potential dehydration, which is a common concern in hyperglycemic states. Administering normal saline (NS) or lactated Ringer’s (LR) solution at a volume of 1000 mL is crucial as it helps rehydrate the patient and improve circulation, especially if the patient is experiencing symptoms of hyperglycemia such as increased thirst and urination, which can lead to dehydration.

This approach allows for stabilization of the patient’s condition before administering insulin, which may follow fluid resuscitation. Insulin can be initiated to lower BGL; however, it should not be the first step without addressing fluid deficits.

The other options do not adequately address the initial management needs in hyperglycemic presentations:

• Insulin administration might lower blood glucose, but without adequate fluid support, it could lead to further complications.

• Dextrose 50% is used to treat hypoglycemia, making it inappropriate for high BGL scenarios.

• Carbohydrates are contraindicated since they would increase the blood glucose level, exacerbating the hyperglycemic condition.

Thus,