hyperglycemia Flashcards
Define Hyperglycemia
is defined as fasting blood glucose of 126mg/dL or higher
Risk factors of hyperglycemia
Modifiable: certain steroid medication, illness/infection, chronic stress, insomnia, hight carbohydrate diet, sedentary life, smoking, high stress
Nonmodifiable: genetic or familiar predisposition to a metabolic disorder(diabetes mellitus/ metabolic syndrome)
Manifestation sof hyperglycemia
- increase urine output (polyuria)
- thirst (Polydipsia)
- weight loss
- increased hunger (polyphagia)
- dry mucous membranes
- decreased BP
- Increased HR
- changes in cognition(confused, lethargic, comatose)
- abdominal pain
- nausea/vomiting
- fruity breath
- fast shallow respirations (Kussmauls)
Other causes for hyperglycemia
- missing or administering improper doses of meds for DMT1 and DMT2 (insulin)
- improper admin technique for insulin
- using expired insulin
- non-adherance to diet/exercise plans
how would you define Hemoglobin A1c?
average blood glucose levels over 2-3 month period
Hemoglobin A1c ranges
Goal is less than 6%
* 5.9% or less is no diabetes
* 7% (154mg/dL) is good diabetes control
* 8%(183mg/dL) to 9%(212mg/dL) is fair diabetes control
* 9% (212mg/dL) or higher is poor diabetes control
Labs used for hyperglycemia
- blood glucose testing(fasting=126mg/dL or more) (postprandial 180mg/dL or more)
- Hemoglobin A1c
when would CT scans, ultrasound or MRI be used for hyperglycemia
- when it is caused by a tumor
- or to evaluate the disease trajectory
what is the role of a nurse when dealing with a patient with hyperglycemia?
- monitor glucose
- administer medication
- Ensure that care is delivered in the client’s preferred language by accessing interpreter services when necessary.
- connect authentically with the client
- collaborate with the Health care team
what role does the nurse play in client education?
- educate on how to monitor blood glucose levels
- set a target blood glucose level
- Proper storage of equipment and test strips is important. Tell clients to avoid exposing test strips to extreme temperatures or moisture
- Manage and dispose of sharps appropriately
- minimize infection risk
- obtain medication ID bracelet
- monitor urine for ketones
- review triggers for hyperglycemia
- management of medication
what to do if hyperglycemic crisis occurs?
ASSESS:
*vital signs
* hemodynamic stability
* electrolyte levels
* mental status
what solutions might the nurse include:
- making dietary changes
- adjust physical activity
- recover from illness
- limit stress
- review medications surrently taking
- improve hydration
- adjust frequency of self monitoring
use of sliding scale insulin
is highly discouraged in acute care settings because its a recative treatment.
Basal or basal plus bolus id preferred
how much exercise is recommended?
Frequency: 2 to 3 times per week
Intensity: 60-80% of maximum HR
Time: 30 miniutes/ 5days/ week total of 150 min/ week; 5 min wam up and cool down
treatment for hyperglycemia involves?
- lifestyle modification(diet, excercise)
- oral medication
- treatment with insulin
- instruction on weight loss or weight maintenance methods
- change in portion size and caloric intake
- for chronic hyperglycemia collaborate with endocrinologist
pharm therapy for hyperglycemia
- Sulfonylureas
- Biguanides
