Hyperglycemia/Hypoglycemia Esther Kihuga, Karen Lee, Lisa Le, Jessica Teng, Rossana Aquino, Jennifer Park, Carmen Tsui, Elizabeth Cheatham, Malina Rowell, Stacey Dao, Tina Nguyen, Farid Abdullah

What causes Hypoglycemia? Insufficient food / delayed meal or snack Excess insulin or excess oral hypoglycemic agents Too much physical activity Too much exercise  using up too much glucose

Physical Manifestations of Hypoglycemia Shakiness/tremors Nervousness/anxiety Sweating/clamminess Hunger Irritability, confusion, and bizarre behavior Tachycardia Headache Weakness/fatigue If not treated – can lead to seizures, coma, and death. Know how to recognize these symptoms early because these symptoms develop quickly and if not treated, can lead to serious complications

How to correct hypoglycemia Administer: 3-4 glucose tablets 1 serving of glucose gel (equal to 15 grams of carbohydrate) ½ cup or 4 ounces of a regular soft drink 1 cup or 8 ounces of milk 5-6 pieces of hard candy 1 tablespoon of sugar or honey **Amounts varies among individual** Glucose gel = “cake frosting” but way more expensive and for medical use

Nursing implications for hypoglycemia Assess: Level of consciousness Respiratory and circulatory status Blood glucose Existence of IV access Time and amount of insulin doses Amount of food eaten Blood glucose check often What do you do if patient is unconscious? IM glucagon, glucose gel, or IV dextrose (very little!)

What Causes Hyperglycemia? Inadequate administration of insulin/medication – T1DM Insufficient insulin for body’s demands – T2DM skipping or forgetting insulin/medications Eating too much Not enough exercise Stress from illness – ex: flu and infection In T1DM, patient may not have given themselves enough insulin In T2DM, the body is still producing insulin, but it is not enough for the body’s demands Too much food intake without the adequate amount of insulin

Physical manifestations of hyperglycemia Extreme thirst Dry or itchy skin Hunger Blurred vision Drowsiness Infections Increased urination Video on symptoms of hyperglycemia The 3 P’s: Polydipsia, polyphagia, polyuria

How to correct hyperglycemia Insulin therapy Electrolyte stabilization Treatment/prevention of long term complications Main goal is restoration to near normal blood glucose levels

Nursing implications for hyperglycemia Educate patient on signs and symptoms Assess patient for signs of DKA and infection Check patient history of diabetes, hyperglycemia, and hypoglycemia Assessing patient for signs of DKA: fruity smelling breath, n/v, SOB, dry skin, weakness, confusion, coma Infection signs: fever

Any questions?