A home health client has a glucose reading of 392 mg/dL during a visit. Which action should the nurse prioritizes today?

• A. Stabilize the client's blood glucose levels
• B. Administer broad-spectrum antibiotics
• C. Reinforce insulin self-administration education
• D. Assist with wound care planning

Answer: (A)

When glucose is this high, the immediate priority is to stabilize glycemic control to prevent acute complications. A reading around 392 mg/dL signals significant hyperglycemia that can lead to dehydration, electrolyte imbalances, and progress to serious conditions like diabetic ketoacidosis or hyperosmolar hyperglycemic state. The nurse should focus on bringing glucose toward a safer range by verifying that the client has taken prescribed insulin and is adequately hydrated, and by communicating with the provider to adjust the insulin regimen if needed. Look for signs of ketosis or dehydration and assess for possible triggers such as infection or nonadherence. Starting antibiotics or concentrating only on wound care isn’t the urgent need here unless an infection is actually present, and while reinforcing insulin education is important, it should follow addressing the current hyperglycemia.