Hypoglycemia

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Study Tools For Hypoglycemia

Hypoglycemia Management (Mnemonic)
Hypoglycemia – Signs and Symptoms (Mnemonic)
Diabetes Pathochart (Cheatsheet)
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Outline

Overview

  1. Hypoglycemia
    1. Low blood sugar <70
    2. Not enough energy for body function

Nursing Points

General

  1. Blood sugar regulation
    1. Pancreas
      1. Releases insulin
      2. Insulin moves glucose into cells
    2. Liver
      1. Breaks down stored glycogen
      2. Gluconeogenesis=glucose produced from non-carbs (reserves in body)
      3. Glucose ready to use
  2. Alterations in blood sugar
    1. Sepsis
      1. Impairs gluconeogenesis
      2. Higher insulin release
    2. Alcohol
      1. Inhibits gluconeogenesis
    3. Medications
      1. Insulin
      2. Metformin
      3. Glipizide
    4. Over exertion

Assessment

  1. Presentation
    1. Sweaty
    2. Shaky
    3. Double vision
    4. Seizures
    5. Confusion/loss of consiousness
    6. Death
  2. Check blood sugar level
    1. Glucometer
    2. Lab work

Therapeutic Management

  1. Monitor blood sugar
    1. Low (<70)
      1. If conscious ->PO glucose, juice, food
      2. If unconscious ->IV glucagon
      3. Recheck blood sugar 15 minutes later
  2. ALWAYS double verify insulin

Nursing Concepts

  1. Glucose metabolism
    1. Break down of carbs
    2. Break down of reserves
    3. Glucose for body functions
  2. Lab values
    1. Blood sugar level
  3. Nutrition
    1. Balanced diet
    2. Diabetics
      1. Count carbs
      2. Take insulin with meals

Patient Education

  1. Eat well balanced diet
  2. Do not fast
  3. Diabetics -> check blood sugar levels regularly

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Transcript

Hey guys! Welcome to the lesson on hypoglycemia!

Hypoglycemia is where the blood sugar is too low. Our body needs glucose to function, so if there isn’t enough, our body will begin to slow down and eventually shut down. Let’s explore how blood sugar is regulated in the body.

So, to understand hypoglycemia, you need to know how blood sugar is regulated in the body. The pancreas releases insulin to move glucose into the cells for the body to use. The liver breaks down stored glycogen. Gluconeogenesis is the process of producing glucose from non-carbs when the body needs it. This happens if you’re not eating enough carbs, or you haven’t eaten in a while. Next let’s discuss alterations in the blood sugar levels.

So sometimes things cause our blood sugar to decrease to the point where our body cells aren’t getting the energy that they need for body function. Sepsis impairs gluconeogenesis and can cause higher insulin release. I actually had a patient that was septic and her blood sugars were ranging 15-30 even after treating the hypoglycemia multiple times. Alcohol can also inhibit the breakdown of reserves for energy, so diabetics have to carefully check blood sugars when drinking. Medications like insulin, metformin, and glipizide are meant to decrease the blood sugar levels to normal levels when taken correctly. Too much or not enough food with these medications can cause hypoglycemia to occur. If we over exert ourselves by using more energy than our body has available, we may experience hypoglycemia. Next let’s talk about what this patient will look like.

The patient with hypoglycemia may be sweaty and shaky and see double vision. This could result in seizures, confusion, loss of consciousness, and even death. Guys, remember that your patient may not have symptoms at all, and others may know right away that they have a low blood sugar because of the way they feel. Next let’s talk about how we check the blood glucose level.

Now, there are two ways to check a patient’s blood sugar level. Glucometers small devices that can check the glucose level with a drop of blood from the patient’s fingertip. The doctor may also order glucose lab work where blood is drawn from the vein. So, if your patient has a low blood sugar shown on the glucometer or lab value, you will need to give them glucose. If they are alert and able to eat, they may either be given PO glucose tabs, juice, or food. If they aren’t alert or able to eat, IV glucagon may be given. There have also been times where I had to do both, like with that septic patient with super low blood sugars. Also remember that you should ALWAYS get someone else to verify that your insulin is correct before you administer it to the patient. This helps to avoid errors that could result in hypoglycemia.

Our patient with hypoglycemia should be educated to eat a balanced diet, and avoid fasting. Diabetics need to check their blood sugars regularly with a glucometer at home. Some diabetic patients even have devices that attach to their side and let them know if their blood sugar is low.

The priority nursing concepts for the patient with hypoglycemia are glucose metabolism, lab values, and nutrition.

Let’s review the key points about hypoglycemia. Hypoglycemia is when the blood sugar is too low and the body is deficient in energy. Blood sugar is regulated by the pancreas and liver. The pancreas makes insulin which pushes the glucose into cells for use. The liver helps to breakdown non carbs into sugar for the body to use. Glucose levels may vary when the patient has sepsis or drink alcohol because they alter that gluconeogenesis process that occurs in the liver. Medications like insulin, metformin, and glipizide help lower the blood sugar in diabetics, but if taken too much or without food they could lower the blood sugar too far causing hypoglycemia. Exercising too much or not eating can also lead to low blood sugars. The hypoglycemic patient might be sweaty, shaky, or even have a seizure. They will eventually lose consciousness and die if the hypoglycemia isn’t treated. If a low blood sugar is suspected, a glucometer or lab draw may be used to check the level. If it is less than 70, we may give the patient glucose tabs, juice or food. If unconscious or unable to eat, we may administer IV glucagon to bring the sugar up. Make sure you recheck the blood sugar 15 minutes later if it was low.

I hope you have a clear understanding of hypoglycemia and how to manage it. Now go out and be your best self today, and as always, happy nursing!

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Exam 4

Concepts Covered:

  • Shock
  • Shock
  • Acute & Chronic Renal Disorders
  • Documentation and Communication
  • Preoperative Nursing
  • Factors Influencing Community Health
  • Immunological Disorders
  • Peripheral Nervous System Disorders
  • Studying
  • Oncology Disorders
  • Intraoperative Nursing
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Vascular Disorders
  • Renal Disorders
  • Hematologic Disorders
  • Medication Administration
  • Cardiac Disorders
  • Postoperative Nursing
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of Pancreas
  • Disorders of the Posterior Pituitary Gland
  • Central Nervous System Disorders – Spinal Cord
  • Renal and Urinary Disorders
  • Lower GI Disorders
  • Fundamentals of Emergency Nursing
  • Perioperative Nursing Roles
  • Musculoskeletal Trauma
  • Gastrointestinal
  • Renal
  • Respiratory Disorders

Study Plan Lessons

02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Admissions, Discharges, and Transfers
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
AIDS Case Study (45 min)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Biopsy
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Chemotherapy Patients
Chronic Kidney Disease (CKD) Case Study (45 min)
Chronic Renal (Kidney) Module Intro
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Continuous Renal Replacement Therapy (CRRT, dialysis)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Dialysis & Other Renal Points
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Epoetin (Epogen) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Epoetin Alfa
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fluid Volume Overload
Genitourinary (GU) Assessment
Genitourinary Course Introduction
Genitourinary Trauma for Certified Emergency Nursing (CEN)
Genitourinary Infections for Certified Emergency Nursing (CEN)
Hemodialysis (Renal Dialysis)
Hematology/Oncology/Immunology Course Introduction
Hematology Module Intro
Hemorrhage Nursing Interventions for Certified Perioperative Nurse (CNOR)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Immunology Module Intro
Implant Preparation for Certified Perioperative Nurse (CNOR)
Implant Records and Tracking for Certified Perioperative Nurse (CNOR)
Implant Verification and Availability for Certified Perioperative Nurse (CNOR)
Intake and Output (I&O)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Kidney Cancer
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Nephrotic Syndrome Case Study (Peds) (45 min)
Neurogenic Shock for Certified Emergency Nursing (CEN)
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Scleroderma
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Rheumatoid Arthritis
Obstruction for Certified Emergency Nursing (CEN)
Obstructions for Certified Emergency Nursing (CEN)
Patient and Healthcare Team Safety (Disasters, Environmental Hazards) for Certified Perioperative Nurse (CNOR)
Patient Positioning
Patient Positioning (Performance) for Certified Perioperative Nurse (CNOR)
Peritoneal Dialysis (PD)
Protein in Urine Lab Values
Renal (Kidney) Failure Labs
Renal Failure for Certified Emergency Nursing (CEN)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Scleroderma Symptoms Nursing Mnemonic (CREST)
Sepsis Concept Map
Sepsis for Certified Emergency Nursing (CEN)
Sepsis for Progressive Care Certified Nurse (PCCN)
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Systemic Lupus Erythematosus (SLE)
Vitamin D Lab Values
Who Needs Dialysis Nursing Mnemonic (AEIOU)
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values