Progressive Care Nursing Certification (PCCN) Practice Exam

A patient admitted with sepsis has two consecutive blood sugar readings greater than 180. What should the nurse anticipate?

1. No treatment, as elevated blood sugar is expected

2. Administration of insulin to maintain blood sugar at or below 180

3. Monitoring blood sugar unless it exceeds 200

4. No treatment to avoid increased mortality from rebound hyperglycemia

The correct answer is: Administration of insulin to maintain blood sugar at or below 180

The focus on managing blood glucose levels in a patient with sepsis is crucial due to the potential for hyperglycemia to contribute to adverse outcomes. Elevated blood sugar can exacerbate the inflammatory response, impair immune function, and increase the risk of complications. Therefore, prompt and appropriate intervention is necessary when blood sugar readings exceed established thresholds. Administration of insulin to maintain blood sugar at or below 180 is indeed the recommended action in this scenario. By keeping blood glucose levels within a controlled range, the healthcare team can help mitigate the negative effects of hyperglycemia on the patient's condition. Insulin therapy is a standard practice in the management of critically ill patients, particularly those with sepsis, as it can improve outcomes by reducing morbidity associated with elevated glucose levels. The other options do not adequately address the importance of controlling blood sugar in this context. Assuming no treatment is needed may overlook significant risks associated with sustained hyperglycemia. Monitoring alone without addressing elevated levels may allow for continued glucose elevation, which could lead to further complications. Similarly, avoiding treatment for fear of rebound hyperglycemia fails to recognize the importance of proactively managing blood sugar levels in the setting of sepsis. Therefore, maintaining blood glucose at or below the threshold through insulin administration is the most clinically sound