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Treating a Hypoglycemic Patient

Treating a Hypoglycemic Patient. Kate DeRonde Lindsay Gigon Lauren Deming. Adrenergic Symptoms • Anxiety • Diaphoresis • Headache • Hunger • Hypotension • Nervousness • Pallor • Shakiness • Tachycardia • Tachypnea • Tingling in extremities. Neuroglycopenic Symptoms

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Treating a Hypoglycemic Patient

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  1. Treating a Hypoglycemic Patient Kate DeRonde Lindsay Gigon Lauren Deming

  2. Adrenergic Symptoms • Anxiety • Diaphoresis • Headache • Hunger • Hypotension • Nervousness • Pallor • Shakiness • Tachycardia • Tachypnea • Tingling in extremities Neuroglycopenic Symptoms • Abnormal behavior • Blunted mental activity • Blurred vision • Confusion • Difficulty concentrating • Dizziness • Fatigue/sleepiness • Irritability • Loss of consciousness • Loss of fine motor skills • Numbness • Personality changes • Recall difficulty • Slurred speech • Seizures • Weakness

  3. Blood Glucose Level <70for a Conscious Patient -immediately have patient ingest 15g of simple carbohydrate (ie: 4oz of juice or regular soda) -recheck glucose level in 15 mins -if glucose level is still <70 give another 15 grams of simple carbohydrate -recheck glucose level in 15 mins -if glucose levels remain <70 call MD -when relieved have patient ingest a long acting carbohydrate, such as a snack (ie: crackers with cheese or peanut butter), or meal if it is time -recheck glucose in 45 minutes

  4. For Worsening, Unconscious or Patients with Impaired Swallowing -if patient has IV access administer 20-50ml of D50 IV at 3ml/min -if no IV access administer 1mg of glucagon IM and turn patient on side -call MD -when the patient is alert ingest snack (ie: crackers with cheese or peanut butter) or scheduled meal if it’s time -recheck glucose in 45 mins

  5. Proper PO Choices

  6. Evidence Based Practice According to the American Diabetes Association, glucose (15 to 20 g) is the preferred treatment for the conscious individual with hypoglycemia, although any form of carbohydrate that contains glucose may be used. If testing 15 minutes after treatment shows continued hypoglycemia, the treatment should be repeated. After glucose level returns to normal, the individual should consume a meal or snack to prevent recurrence of hypoglycemia.

  7. Documenting • All assessment findings and VS • Notification of MD: date & time of calls made and times of MD response • All MD orders taken and interventions made; ALL patient responses to care • If MD overrules lab draw document this as well, physicians choosing to not have a laboratory draw for their patients take full responsibility. • All patient/family teaching done and their level of understanding

  8. Important to remember: • Make sure your using an accurately calibrated glucometer • A prompt but moderate approach is best. Overtreatment may cause rebound hyperglycemia. • Document, Document,Document!

  9. Test Your Knowledge • Name 3 objective symptoms of hypoglycemia. How might the patient report feeling? • What is the normal range for a blood glucose level? • Name 3 nursing interventions for a hypoglycemic patient. 4. List important aspects for comprehensive documentation.

  10. Bibliography Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2011). Davis's drug guide for nurses (12th ed.). Philadelphia: F.A. Davis. Diabetic Hypoglycemia. (n.d.). NetCE Continuing Education Online. Retrieved February 13, 2013, from http://www.netce.com/coursecontent.php?courseid=714#chap.6 Kelly, R. C., & Owens, B. B. (2010). Hypoglycemia treatment in the ambulatory care setting. AAACN Viewpoint, 32(6), 1. Lewis, S. M. (2011). Medical-surgical nursing: assessment and management of clinical problems (8th ed.). St. Louis, Mo.: Elsevier/Mosby. Lowth, M. (2012). Hypoglycaemia Prevention and management. Practice Nurse,42(18), 12-16.

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