Hypoglycemia Flashcards
What is hypoglycemia and why does it occur?
Low blood pressure glucose levels and they are less than 4 mmol/L. May occur because of too much insulin in proportion to glucose in blood or metabolic shifts. Too much exercise, patient fasting, food intake/peak action of hypoglycemic meds.
S+S of hypoglycemia?
Confusion, irritability, diaphoresis, tremors, weakness, hunger, visual disturbances, cool/clammy need a candy? Untreated it can lead to changes in LOC, seizures, coma, and death.
If BGM if <4 then what do you do?
Begin treatment. If able to swallow/conscious/tube feed- treat with 15 g of fast acting carbs (4 tabs of 4 grams glucose chewable tabs, repeat BGM q15 min and treatment again if its still >4). If altered LOC/unable to swallow- check ABCs, attempt to establish IV access, IV treatment of dextrose over 1-3 minutes/recheck BGM q15 min. IM/subcut- administer glucagon 1 mg into deltoid/anterior thigh and check BGM q15 min.
What is glucagon?
It regulates glucose levels through modulation of hepatic glucose production. It counteracts the action of insulin.
What do you do following initial treatment?
Provide snack (carb or protein) to maintain glucose levels, especially if meal is more than an hour away. Like cheese and crackers or a peanut butter sandwich.
What can changes in colour/sensation be a sign of?
Diabetic neuropathy. Patients often cant feel pressure or sores on their feel. They are difficult to heal so make sure to always check the feet.
Modifiable risk factors for type 2 diabetes?
Diet, exercise, smoking, alcohol use, obesity, and lifestyle factors.
Can someone with hypoglycemia sometimes not experience warning S+S?
Yes
What is diabetes and types?
Ability to produce and utilize insulin is impaired which results in impaired glucose metabolism.
Type 1- autoimmune disorder where pancreas beta cells are destroyed b/c immune system attacks insulin secreting cells
Type 2- progressive and person has insulin resistance that progresses to decreased beta cell secretion of insulin
What happens when the body doesn’t have glucose?
Body will break down fats/proteins to provide energy and increase levels of balancing hormones to make glucose from other sources
Complications r/t chronic hyperglycemia?
- Cardiovascular disease- increased risk
- Cerebrovascualr disease- increased risk for strokes
- Reduced immunity- high blood glucose reduces WBC activity/inhibits gas exchange
- Eye/vision complications- can cause blindness
- Diabetic peripheral neuropathy- progressive deterioration of nerve function that results in sensory loss
- Diabetic autonomic neuropathy-
- Diabetic neuropathy- change in kidneys that reduces kidney function and can lead to failure
- Sexual dysfunction- damage to nerve/vascular tissue
- Cognitive dysfunction- risk for developing dementia
What is the A1C value?
Test that measure how much glucose attaches to hemoglobin over last 3 months and it indicates an average glucose level
If a patient has hypoglycemia, what symptoms would indicate need for additional treatment?
Persistent confusion and irritability
Good understanding of hypoglycemic episodes for patients?
Having a source of sugar on hand for hypoglycemic episodes
After stabilizing pt with hypoglycemia, what actions should the nurse take to prevent future episodes?
Review pt dietary habits/suggest maintaining a regular meal schedule, teach pt to regularly monitor their blood glucose levels, and educate pt about recognizing early S+S of hypoglycemia.
