A client exhibits severe lethargy and a blood glucose level of 38 mg/dL. What health problem should the care team suspect?

In the context of severe lethargy and a critically low blood glucose level of 38 mg/dL, the care team should suspect adrenal insufficiency. This condition occurs when the adrenal glands do not produce adequate amounts of hormones, particularly cortisol, which plays a crucial role in glucose metabolism and maintaining blood sugar levels.

When cortisol levels are insufficient, the body struggles to manage blood glucose levels, leading to hypoglycemia, as seen in this client. The lethargy can also be attributed to the overall lack of adrenal hormones, which affects energy levels and metabolic functions.

While other conditions such as diabetes mellitus can also present with altered levels of blood sugar, they typically cause hyperglycemia rather than hypoglycemia unless there are specific circumstances like insulin overdose. Cushing’s disease relates to an excess of cortisol and is characterized by high blood glucose levels, not low. Kidney disease, while it can have systemic impacts, does not directly account for the acute hypoglycemia seen here.

Thus, adrenal insufficiency is the most consistent diagnosis given the symptoms of severe lethargy and low blood glucose.