Hypoglycemia concept map PDF

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Summary

Download Hypoglycemia concept map PDF

Description

Disease: Hypoglycemia -

Occurs when there is too much insulin in proportion to available glucose in the blood This causes blood glucose to drop to less than 70mg/dL When that happens counter regulatory hormones are released and the ANS is activated Suppression of insulin secretion and production of glucagon and epinephrine provide a defense from hypoglycemia Can occur at anytime Mostly occurs when the OA or insulin is t its peak of action or when the pts daily routine is disrupted Can occur with non-insulin injectable agents or OAs Can also occur when blood glucose levels fall too quickly

S/S: Manifestations can mimic alcohol production Release of epinephrine causes: -

Shakiness Hunger Palpitations Nervousness Diaphoresis Anxiety Pallor

Hypoglycemia causes: -

Difficulty speaking Visual disturbances Stupor Confusion Coma

Untreated hypoglycemia: -

Loss of consciousness Seizures Coma Death

Hypoglycemia unawareness:

-

Condition in which pt does not experience the warning signs and symptoms of hypoglycemia until the glucose levels reach a critical point T may become incoherent, combative, or lose consciousness Often r/t autonomic neuropathy of diabetes

At risk: -

pts who have repeated episodes of hypoglycemia Older pts Pts who use beta adrenergic blockers

Causes of hypoglycemia: -

r/t a mismatch in timing of food intake and the peak action of insulin or oral hypoglycemic agemts that increase endogenous insulin secretion giving too much insulin or medication ingesting too little food delaying time of eating performing unusual amounts of exercise

nursing management: -

can usually be quickly reversed is blood glucose less than 70mg/dL immediately begin treatment greater than 70mg/dL investigate other causes of symptoms if pt has signs of hypoglycemia and monitoring equipment is not available or the pt has a history of fluctuating blood glucose levels, hypoglycemia should be assumes and treated pt should ingest complex carb after recovery to prevent repeat hypoglycemia

Rule of 15: -

15g of a simple carb Recheck blood glucose 15 min later If less than 70mg/dL, ingest another 15g of carb Recheck 15 min later If no improvement after 2-3 doses of 15g of carbs, alert HCP

Avoid treatment with arbs with fat in it as ft can slow the absorption glucose and cause a delay in treatment Avoid overtreatment with large amounts of quick acting carbs In an acute care setting pt can be treated 20-50mL of 50% dextrose IV push If pt is not alert or thare is no IV access inject 1mg of glucagon IM or subQ

Nausea is a common reaction after glucose injection Prevent aspiration if vomiting occurs Turn pt on side until they become alert Pt with minimal glycogen stores will not respond to glucagon -

Alcohol related hepatic disease Starvation Adrenal insufficiency

Teach family members about hypoglycemia and how to inject glucagon Explore with pt why hypoglycemia might of happened...