ad.hyp.Tx guideline

Question 1

symptoms of mild hypoglycemia

Answer 1

autonomic symptoms 
-sweating
-hunger
-anxiety
-trembling
-tingling
-nausea
-palpitations
SHATT N P

person has ability to self treat

Question 2

can person sef treat w moderate hypoglycemia

Answer 2

yes

Question 3

symptoms moderate hypoglycemia

Answer 3

autonomic and

neuroglycopenic symptoms

• confusion
• difficulty concentrating
• difficulty speaking
• headache
• dizziness
• drowsiness
• tiredness
• weakness
• vision changes

Question 4

severe hypoglycemia can pt self treat

Answer 4

requires the assistance of another person and may be unconscious

Question 5

if pt has mild to moderate hypoglycemia ____mmol/L

Answer 5

2.8-3.9mmol/L

Question 6

if pt has mild to moderate hypoglycemia what do
bg of__
-oral ingestion of ___
if pt is ysphagic use ____

Answer 6

2.8-3.9mmol/L
oral ingestion of 15g carbohydrates.
can use glucose gel if dysphagic

Question 7

how high should pts blood glucose get if they were mild to moderately hypoglycemic

Answer 7

4.0mmol/L

Question 8

when should you inform dr of hypoglycemia

Answer 8

if pt has episode of hypoglycemia and (lookup)
-verbally by phone if:
the pt has 3 or more incidents during a hospital stay
blood glucose less than 2.8mmol/L

Question 9

once blood glucose is stabilized after mild-moderate what do

Answer 9

to prevent repeat hypoglycemia the person should have their usual meal or snack. if meal is more than an hr away give protein and carbs of at least 15g carbs

Question 10

fruit juice or drink 4 ounces how much carbs

Answer 10

10-15 grams carbohydrates. good alt for people in their homes

Question 11

are hypoglycemic episodes serious?

what % of pts get them each year

Answer 11

yes. they an lead to complications although theye rarely fatal

can be assoc w serious, ST clinical sequelae

Question 12

severe hypoglycemia is ___mmol/L

Answer 12

less than 2.8mmol/L

Question 13

how many grams should pt ingest if severe hypoglycemic but not unconscious
preferably as____

Answer 13

20

glucose tablets

Question 14

after giving severe H pt carbs what do

Answer 14

retest their blood glucose 15min later

Question 15

if you retest a servely hypoglycemic pts blood glucose and its still less than ____ you should give them____

Answer 15

4.0mmol/L give them another 20g carbs. repeat this until pt blood glucose is over 4.0mmol/L

Question 16

when do autonomic symptoms appear

Answer 16

when blood glucose levels of less than 3.1mmol/L

this number is not absolute. it varies w antecedent glucose control in the indiv

Question 17

what blood glucose do neuroglycopenia symptoms appear at

Answer 17

2.5mmol/L

this number is not absolute. it varies w antecedent glucose control in the indiv

Question 18

what to do for pt w severe hypoglycemia thats unconscious

Answer 18

give 25g IV glucose GIVEN AS 50ML OF D50W over 1-3mins or give 1mg glucagon SQ or IM if theres no IV access
-wait 10 minutes, retest blood glucose and retreat with either the 25g IV glucose or 1mg glucagon if the blood glucose remains less than 4.0mmol/L
-inform Dr ASAP
document

Question 19

considerations for Tx of unconscious severley hypoglycemic pt

Answer 19

in emaciated or undernourished pts or those w uremia or hepatic disease, glucagon isnt effective. Must give IV

Question 20

Pt is NPO and hpoglycemic what do

Answer 20

• each person is diff
• taking w gel or tabs w small amount of water doesnt chnage NPO status
• if nasogastric tube administer 1 tube of the glucose gel orally

Question 21

when your adult pt has low blood sugar whats first step that should be taken

Answer 21

check blood glucose stat

Question 22

if pt meal is more than an hour away what should they do after having had mild to moderate hypoglycemic episode

Answer 22

if meal is more than an hr away give protein and carbs of at least 15g carbs