patient care report of hypoglycemia

Symptoms

• Wear a medical identification bracelet in case you lose consciousness.
• Discuss it with your family and friends so they can support and help you.
• Tell your coworkers what you do to manage your condition.
• Talk to your nurse and teachers at school.
• Join a support group if your condition makes it difficult to manage your daily responsibilities. ...

Causes

Look out for these surprising triggers that can send your blood sugar soaring:

• Sunburn —the pain causes stress, and stress increases blood sugar levels.
• Artificial sweeteners—more research needs to be done, but some studies external icon show they can raise blood sugar.
• Coffee—even without sweetener. ...
• Losing sleep—even just one night of too little sleep can make your body use insulin less efficiently.

More items...

Prevention

Hypoglycemia tends to present as a cluster of symptoms, and they often occur together. The most common signs of dangerously low blood sugar include: Dizziness, disorientation, light-headedness, and an inability to think clearly. Hunger, especially if you’ve just eaten. Heightened irritability, confusion, and anxiety.

Complications

• Shakiness
• Irritability
• Confusion
• Tachycardia (elevated heart rate)
• Hunger

How to cure hypoglycemia permanently?

What foods raise glucose levels?

What are the first signs and symptoms of hypoglycemia?

How to check for hypoglycemia?

How do you assess a patient with hypoglycemia?

If you have signs or symptoms of low blood sugar, check your blood sugar level with a blood glucose meter — a small device that measures and displays your blood sugar level. You have hypoglycemia when your blood sugar level drops below 70 mg/dL (3.9 mmol/L ).

What is the nursing diagnosis for hypoglycemia?

Nursing Diagnosis: Unstable Blood Glucose Level related to insufficient checking of blood sugar levels and lack of compliance to proper diabetes management secondary to hypoglycemia as evidenced by fatigue and tremors.

What should a nurse do when a patient has hypoglycemia?

Severe hypoglycemia can be treated with intravenous (IV) dextrose followed by infusion of glucose. For conscious patients able to take oral (PO) medications, readily absorbable carbohydrate sources (such as fruit juice) should be given.

How do you write a nursing diagnosis?

A nursing diagnosis has typically three components: (1) the problem and its definition, (2) the etiology, and (3) the defining characteristics or risk factors (for risk diagnosis). BUILDING BLOCKS OF A DIAGNOSTIC STATEMENT. Components of an NDx may include problem, etiology, risk factors, and defining characteristics.

What are the 4 types of nursing diagnosis?

There are 4 types of nursing diagnoses: risk-focused, problem-focused, health promotion-focused, or syndrome-focused.

How do you manage a patient with hyperglycemia?

Your doctor may suggest the following treatments:Get physical. Regular exercise is often an effective way to control your blood sugar. ... Take your medication as directed. ... Follow your diabetes eating plan. ... Check your blood sugar. ... Adjust your insulin doses to control hyperglycemia.

What are nursing interventions for hyperglycemia?

Emergency Treatment for Severe Hyperglycemia.Replacement of fluids. The patient will be given fluids — usually intravenously — until rehydration. ... Replacement of electrolytes. Electrolytes are minerals in the blood that the tissues require to function effectively. ... Insulin administration.

What 6 things should you look for to identify hypoglycaemia?

If blood sugar levels become too low, hypoglycemia signs and symptoms can include:Looking pale.Shakiness.Sweating.Headache.Hunger or nausea.An irregular or fast heartbeat.Fatigue.Irritability or anxiety.More items...•

What is a nursing diagnosis for high glucose?

Diabetes mellitus (DM) is a chronic disease characterized by insufficient insulin production in the pancreas or when the body cannot efficiently use the insulin it produces. This leads to an increased concentration of glucose in the bloodstream (hyperglycemia).

Is unstable blood glucose a nursing diagnosis?

Risk for unstable blood glucose level (00179) is a NANDA International, Inc. (NANDA-I) nursing diagnosis (ND), defined as "Vulnerable to variation in blood glucose/sugar levels from the normal range, which may compromise health" 1 .

What are nursing interventions for hyperglycemia?

Emergency Treatment for Severe Hyperglycemia.Replacement of fluids. The patient will be given fluids — usually intravenously — until rehydration. ... Replacement of electrolytes. Electrolytes are minerals in the blood that the tissues require to function effectively. ... Insulin administration.

What are some nursing interventions for neonatal hypoglycemia?

However, when faced with an at-risk or symptomatic newborn, treatment strategies for hypoglycemia aim to normalize blood glucose levels. These strategies include enteral feedings, especially more frequent breastfeeding, intravenous (IV) glucose infusion, and pharmacotherapy.

Intended Improvements

The goal of this performance improvement project was to improve patient safety by addressing actions that increase the risk of hypoglycemia or increase blood glucose variability.

Methods

The diabetes committee chose a blood glucose value <50 mg/dL (2.8 mmol/L) as the threshold for severe hypoglycemia because this level is associated with neurological changes ( 2) and acute cardiac events, including cardiac arrhythmia ( 3, 8, 10 ).

Results

As seen in Table 2, 44.1% of hypoglycemic values were related to the use of long-acting or mixed insulin in 2009. A second category, sulfonylureas used before or during hospitalization, was linked to 31.2% of hypoglycemic values.

Discussion

Overall, the rate of severe hypoglycemia <50 mg/dL (2.8 mmol/L) was reduced by >50% in 2014 compared to 2009 (5.20 vs. 11.38 events per 1,000 patient-days in 2014 and 2009, respectively).

Recommendations and Conclusions

This report highlights the importance of further research in this area. Further study is necessary to refine the orders for titration of IV dextrose and timing of the follow-up blood glucose checks proposed in this article. A major challenge is to maintain order simplicity while addressing the importance of individualized treatment.

Acknowledgments

Although the investigator acted as the champion to catalyze change, the multidisciplinary diabetes committee was actively involved throughout, and provider and nurse understanding and support of the project were essential aspects of our success.

Duality of Interest

No potential conflicts of interest relevant to this article were reported.

What is hypoglycemia in diabetes?

What is Hypoglycemia? Hypoglycemia, or low blood glucose, happens when blood glucose levels drop too low. For most people with diabetes this means a glucose less than 70 mg/dl. Hypoglycemia can be caused by skipping a meal or a snack, eating less than usual, taking too much diabetes medication, or more exercise than usual.

How to treat low blood sugar with a carbohydrate diet?

If your blood sugar is still below 70 mg/dl, eat another 15 grams of fast acting carbohydrate food. If you still do not feel better, call your doctor. Step3: Eat a meal or snack 30-60 minutes after treating low blood sugar.

How to treat low blood sugar?

How to treat a low blood sugar: Step 1: Check your glucose. If your glucose is between 51-70 mg/dl, eat or drink 15 grams of carbohydrate to raise glucose. If you your glucose is less than 50 mg/dl, take 30 grams of carbohydrate. Good sources of 15 grams fast acting carbohydrate are: Step 2: Wait 15 minutes, and check your glucose.

Pathophysiology

Hypoglycemia occurs when the blood glucose levels drop below 70mg/dL. Once this happens, the counterregulatory hormones stimulate the autonomic nervous system to elicit a response such as tremors, sweating, irritability, tachycardia and hunger.

Etiology

Causes of hypoglycemia are varied, but it is seen most often in diabetic patients. This condition typically arises from abnormalities in the mechanisms involved in glucose homeostasis. The most common cause of hypoglycemia in patients with diabetes is injecting a shot of insulin and skipping a meal or overdosing insulin

Desired Outcome

The patient is expected to have blood glucose levels above 70 mg/dL and the patient should be able to recognize signs and symptoms of low blood glucose.

What does it mean when your insulin level is 3 microunits?

Insulin level#N#Insulin level > 3 microunits/ml (21 pM) in context of hypoglycemia suggests pathologically excessive insulin levels. This may reflect either endogenous insulin synthesis or exogenous insulin administration.#N#Unfortunately, some synthetic forms of insulin may not be detected by the assay (e.g. glargine).

Is hyperglycemia worse than hypoglycemia?

Hyperglycemia is less dangerous than hypoglycemia. Consider reducing the insulin dose if the patient becomes NPO, or if steroid doses are decreased. Insulin dosing can be tricky. Among all medications, insulin is one of the most prone to serious dosing errors.

Is it safe to do insulin in an acute care setting?

When dosing insulin in an acute care setting, it's always safer to leave the patient in a mildly hyperglycemic range.

Should you have a fingerstick glucose test for hypoglycemia?

Patients with any sort of neurologic alteration (e.g. confusion, seizure, coma) should always have a STAT fingerstick glucose to exclude hypoglycemia.

Is 7 a good glucose target?

A glucose target of <220 mg/dL (<11.1 mM) is fine for most patients. Patients with diabetes and elevated hemoglobin A1C >7 may do better if their glucose is allowed to drift higher (up to ~250 mg/dL) (13.9 mM). When in doubt, dose insulin conservatively. Hyperglycemia is less dangerous than hypoglycemia.

What to do if you have a history of hypoglycemia?

Emphasize the benefits of eating right and on time. Explain the need to eat carbohydrate-rich food before exercising. If your patient has a history of hypoglycemia, advice the patients to be ready with candies or chocolates in case of symptoms appear.

What is hypoglycemia on Tumblr?

Tumblr. Telegram. Mix. Digg. Hypoglycemia refers to low blood sugar or glucose reading in the blood. The severity of its symptoms may seem like diseases but it is not. Hypoglycemia is a sign of an underlying health problem. Most of the time, this condition occurs in medication dependent diabetic patients.

How to prevent unstable glucose levels?

Acknowledge factors that may lead to unstable blood glucose. Verbalize understanding of body and energy needs. Verbalize plan for modifying factors to prevent/minimize shifts in glucose level. Maintain glucose in a satisfactory range.

Can you take allopurinol with diabetes?

The following medications have causes drug-related hypoglycemia: instruct not to take allopurinol, aspirin, probenecid, or warfarin with diabetes medications. Instruct the patient to monitor blood sugar regularly. Familiarize the patients and their relatives with the common signs and symptoms of hypoglycemia.

Can insulin-dependent patients have hypoglycemia?

Patients taking oral hypoglycemic agents and insulin-dependent patients are at risk for hypoglycemia. Hypoglycemia may also occur in people without diabetes, as well. It may be due to the sudden decrease in food intake or excessive use of energy.

What is the blood glucose level of a patient with hypoglycaemia?

Hypoglycaemia is defined as a plasma glucose of less than 3.0 mmol/l. In hospitalised patients, a blood glucose ≤4.0 mmol/L should be treated if the patient is symptomatic. 1. See our blood glucose measurement guide for more details.

How long to administer glucose gel?

Administer glucose gel by mouth (e.g. GlucoGel®). Repeat capillary blood glucose after 10-15 minutes and if the patient is still hypoglycaemic, repeat administration of glucose gel a further 2-3 times. When the patient is fully alert, provide a longer-acting carbohydrate for the patient to eat (e.g. toast).

What is the purpose of measuring blood glucose and ketone levels?

Blood glucose and ketones. Measure the patient’s capillary blood glucose and ketone levels to screen for causes of a reduced level of consciousness (e.g. hypoglycaemia, DKA). A blood glucose level may already be available from earlier investigations (e.g. ABG, venepuncture).

What is a GCS of 8?

Alert a senior immediately if you have any concerns about the consciousness level of a patient. A GCS of 8 or below warrants urgent expert help from an anaesthetist. In the meantime, you should re-assess and maintain the patient’s airway as explained in the airway section of this guide.

What is the purpose of Part One of our two part special on diabetes?

Part one of our two part special on diabetes focuses on the firsthand experience of a patient living with diabetes. We discuss what it is like to be diagnosed with Type 1 diabetes and to live with and manage the condition day-to-day. We hope that this episode will be useful for students, medical professionals, and anyone who wants to understand more about the challenges of managing this condition. Guest: Ashwin Bali