What is the first action in the treatment of hyperglycemia?

The first action in the treatment of hyperglycemia is to start an IV with normal saline. This approach is crucial because hyperglycemia can lead to dehydration, particularly if associated with diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS). Administering normal saline helps to rehydrate the patient, restore electrolyte balance, and potentially dilute the high glucose levels in the blood.

Monitoring blood sugar levels is important for ongoing assessment and management, but it is typically not the primary immediate action. It helps guide treatment decisions but does not address the urgent need to correct dehydration or prevent further complications.

Starting an intravenous line with D10 is not appropriate in the initial treatment of hyperglycemia, as it could exacerbate the patient's high blood sugar by introducing more glucose into the system.

Consulting a specialist can be part of the overall treatment plan, especially for complicated cases, but immediate management of hyperglycemia focuses on stabilization and hydration. Thus, initiating an IV with normal saline is the most appropriate first step in addressing the condition.