{"id":328,"date":"2019-09-17T13:19:05","date_gmt":"2019-09-17T17:19:05","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/?post_type=chapter&p=328"},"modified":"2020-03-23T17:30:25","modified_gmt":"2020-03-23T21:30:25","slug":"9-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/chapter\/9-3\/","title":{"raw":"9.3 Hypoglycemia and hyperglycemia","rendered":"9.3 Hypoglycemia and hyperglycemia"},"content":{"raw":"

Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\r\n
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  1. At 0930 hours, your diabetic patient complains of feeling faint.\u00a0You\u00a0check his blood sugar and get a reading of 2.8 mmol\/L. What actions will you take?<\/strong><\/li>\r\n<\/ol>\r\nAnswer: the nurse should follow the agency\u2019s protocol for treating hypoglycemia. Below is one such example copied from Anderson R. (2018). Clinical Procedures for Safer Patient Care: Thompson Rivers University Edition\u00a0 \u00a0https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/chapter\/9-3-hypoglycemia-and-hyperglycemia\/<\/a><\/em>\r\n\r\n\r\n\r\n\r\n\r\n\r\n
    Capillary Blood Gas (CBG)<\/td>\r\nAble to Swallow<\/td>\r\nPatient Is Not Able to Swallow but Has\u00a0IV Access<\/td>\r\nPatient Is Able to Swallow\u00a0 but Has No IV Access<\/td>\r\n<\/tr>\r\n
    \u2265 4 mmol\/L<\/td>\r\n\r\n
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    • No treatment necessary<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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    • No treatment necessary<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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    • No treatment necessary<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
    2.2 to 3.9 mmol\/L<\/td>\r\nGive 15 g of glucose in the form of:\r\n
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    • 3 to 5 dextrose\/glucose tabs (check the label) (best choice), OR<\/li>\r\n \t
    • 175 ml of juice or soft drink (containing sugar), OR<\/li>\r\n \t
    • 1 tablespoon of honey, OR<\/li>\r\n \t
    • 3 tablespoons of table sugar dissolved in water<\/li>\r\n<\/ul>\r\n \r\n
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      • Note:\u00a0Milk, orange juice, and glucose gels increase blood glucose (BG) levels more slowly and are not the best\u00a0choice unless the above alternatives are not available.<\/li>\r\n \t
      • Repeat CBG every 15 to 20 minutes and repeat above if BG remains below 4 mmol\/L.<\/li>\r\n \t
      • Once BG reaches 4 mmol\/L, give patient 6 crackers and 2 tablespoons of peanut butter. If meal is less than 30 minutes away, omit snack and give patient meal when it is available.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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    • Notify physician.<\/li>\r\n<\/ul>\r\n \r\n
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      • Give 10 to 25 g (20 to 50 ml) of D50W (dextrose 50% in water) of glucose intravenously over 1 to 3 minutes,\u00a0OR\u00a0as per agency policy.<\/li>\r\n<\/ul>\r\n \r\n
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        • Repeat CBG every 15 to 20 minutes until\u00a04 mmol\/L.<\/li>\r\n<\/ul>\r\n \r\n
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          • Continue with BG readings every 30 minutes for 2 hours.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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    • Notify physician.<\/li>\r\n<\/ul>\r\n \r\n
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      • Give glucagon 1 mg subcutaneously (SC) or intramuscularly (IM).<\/li>\r\n<\/ul>\r\n \r\n
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        • Position patient on side.<\/li>\r\n<\/ul>\r\n \r\n
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          • Repeat CBG every 15 to 20 minutes. Give second dose of glucagon 1 mg SC or IM if BG remains below 4 mmol\/L.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
    \u2264 2.2 mmol\/L<\/td>\r\n\r\n
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    • Call lab for STAT BG\u00a0level.<\/li>\r\n \t
    • Continue as above.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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    • Call lab for STAT BG level.<\/li>\r\n \t
    • Continue as above.<\/li>\r\n<\/ul>\r\n<\/td>\r\n
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