A 48-year-old female with type II diabetes, renal failure, and CHF is unconscious. Her blood glucose is 45 mg/dL with focal seizures. Which treatment should be administered immediately?

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Rapidly restore brain glucose. In an unconscious patient with severe hypoglycemia and seizures, the immediate move is to give intravenous glucose to raise the blood sugar quickly. Administer 25 g of dextrose intravenously (a 50% dextrose solution). This promptly reverses the glucose deficit and stops the hypoglycemia-driven seizures.

Sodium bicarbonate wouldn’t address the low glucose and can cause unnecessary electrolyte and fluid shifts, especially in someone with renal failure and CHF. Narcan targets opioid overdose, which isn’t indicated here, and diazepam could worsen CNS depression if the patient is not yet stabilized. If IV access isn’t available, glucagon given intramuscularly is an alternative. After glucose is corrected, continue managing seizures and the underlying conditions.