nursing care in hypoglycemia

Set of activities performed by the nurse to prevent and treat blood glucose levels below 60 mg/dl.

Objectives:

– Maintain the patient’s blood glucose levels within normal or acceptable limits. – To teach the patient and family to identify early signs and symptoms of hypoglycemia.

Equipment:

– Trough. – Sharps container. – Equipment necessary to perform the Basal Blood Glucose Test. – Equipment necessary to perform Intravenous Medication Administration. – Equipment necessary for the Peripheral Catheter Insertion Technique.

Material:

– Material necessary for the procedure of performing Basal Glycemia. – Material necessary for the Intravenous Medication Administration. – Material necessary for the Peripheral Catheter Insertion Technique. – Glucose serum. – Tubes for blood analysis. – Sugar, sweet drinks, etc. – Intravenous glucose ampoules – Nursing records.

Procedure:

– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Request patient and family collaboration. – Assess whether the patient is at high risk of hypoglycemia: patients with vomiting, diarrhea, diabetics, etc. – Determine the presence in the patient of signs and symptoms of hypoglycemia: pallor, diaphoresis, tachycardia, palpitations, hunger, paresthesia, tremors, inability to concentrate, confusion, slurred speech, blurred vision, drowsiness, inability to wake from sleep, seizures, weakness, anxiety, irritability, chills, cold, dizziness, nausea, headache, fatigue, heat, and behavioral changes. – Determine blood glucose levels. – If hypoglycemia is confirmed and the patient is conscious administer simple carbohydrates. After 10-15 minutes repeat control, if glycemia is not normalized, repeat intake until metabolic stabilization. – Notify the physician. – If hypoglycemia does not go back to normal, administer intravenous glucose serum, subcutaneous glucagon or hypertonic glucose serum, according to medical prescription. – Monitor glucose levels until normalization according to nurse and physician criteria. – Modify insulin therapy guidelines according to the previously established algorithm. – Examine previous occurrences of hypoglycemia to determine the cause. – Teach the patient and family the signs or symptoms, risk factors and treatment of hypoglycemia. – Ask the patient to urinate, if unable to assess the need for catheterization. – Collect the material. – Identify the tubes with the patient’s data and send to the laboratory with the analysis form. – Perform hand washing. – Record in the nursing documentation: procedure performed, date and time, incidents and patient’s response.