Case Study 1 1.) Define hypoglycemia. What are hypoglycemic blood glucose values in an adult? Hypoglycemia: Low blood glucose level that results from too much insulin, not enough food, or excess activity. It is defined as the presence of Whipple’s triad: manifestations consistent with low blood glucose, a low plasma glucose concentration, and resolution of symptoms or signs after plasma glucose concentration is raised. Four common causes are: 1.) excess insulin, 2.) deficient intake or absorption of food, 3.) exercise, and 4.) alcohol intake. When blood glucose falls below 70 mg/dl or when the blood glucose level drops rapidly from an elevated level. 2.) Describe the clinical manifestations of hypoglycemia. How low does a…show more content…
Exercise usually causes blood glucose levels to fall in a patient with type 1 DM. Prolonged exercise increases cellular glucose uptake for several hours after exercise. 4.) Briefly define hypothermia, and explain why the client with hypoglycemia is often hypothermic. Hypothermia: marked cooling of core temperature that is below the required normal for normal metabolism and body functions. This is generally considered to be 95.0’F. Produces depression of the central nervous and respiratory systems, vasoconstriction, alterations in microcirculation and coagulation, and ischemic tissue damage. Cold stress increases metabolism.Difference between Hypoglycemia and Hypoglycemia Essay Increased metabolism increases the use of glucose. Once the circulating glucose is used, the body turns to the glycogen stores and if it goes on for too long depletes glycogen stores leading to hypoglycemia. 5.) If an IV access site could not be established, could the 50% dextrose be administered intramuscularly? What is another medication that the HCP might prescribe to treat the client’s hypoglycemia, and what is the medication’s most common adverse effect? No, 50% dextrose cannot be administered IM. It needs to be given slowly and carefully to avoid extravasation because it is hyperosmolar and can damage tissue. Glucagon: Can be given subcutaneously or IM. It is the main counterregulatory hormone and is used as therapy for severe
In Brief Hypoglycemia is a worrisome condition for hospitalized patients. Nurses, physicians, and other health care workers must be vigilant in detecting, treating, and most of all preventing hypoglycemia in diabetic patients. Systems and protocols for treating patients with diabetes guide the health care team in achieving glycemic goals for healing and health promotion while providing a safe environment.
There is widespread appreciation of glycemic control for outpatient management of diabetes. However evidence for tight glucose control for inpatient management is also increasing.Difference between Hypoglycemia and Hypoglycemia Essay
Barriers to tight glucose control stem from concerns about hypoglycemia recognition in patients who are bedridden and those who have altered mental status, who are less likely to be capable of seeking assistance for this condition.2 Diabetes-related cardiovascular events, including stroke and heart disease, are leading reasons for hospitalization. Many of these patients are at risk for hypoglycemia because of their critical health status and altered mental status. Furthermore, medical intervention may place them at risk for sensing signs and symptoms of hypoglycemia.1 The threat of hypoglycemia requires the inpatient team to be vigilant in detecting signs and symptoms, preventing episodes without compromising glycemic control for adequate healing, and treating hypoglycemia episodes appropriately.
Hypoglycemia constitutes a medical emergency; however, most individuals recover completely. In the Diabetes Control and Complications Trial (DCCT), there were > 1,000 episodes of loss of consciousness associated with hypoglycemia. However, there were no deaths, myocardial infarctions, or strokes definitively attributed to hypoglycemia, and to date there is no evidence of brain damage resulting from any of these episodes.Difference between Hypoglycemia and Hypoglycemia Essay
Although no deaths occurred in the individuals participating in the DCCT, hypoglycemia that is not reversed can progress from lethargy to coma and ultimately to death. Even with treatment, there are reported cases of long-lasting severe hypoglycemia leading to transient and even permanent cerebral damage.3
Detection
Hypoglycemia occurs from a relative excess of insulin in the blood and results in low blood glucose levels. The level of glucose that produces symptoms of hypoglycemia varies from person to person and varies for the same person under different circumstances.4 Hypoglycemia is common in insulin-treated diabetic patients and may occur in patients taking an insulin secretagogue. It may range from a very mild lowering of glucose (60–70 mg/dl), with