Pharmacology/Endocrine Drugs
I. Nursing and Interprofessional Management: Hypoglycemia
โHypoglycemia can usually be quickly reversed with effective tx
โAt first sign of hypoglycemia, check the blood glucose is possible
โIf it's less than 70 mg/dL, immediately begin tx for hypoglycemia
โIf the blood glucose is greater than 70 mg/dL, investigate other possible causes of
the S&S
โIf the pt has manifestations of hypoglycemia and monitoring equipment isn't
available/pt has a hx of fluctuating BGL, hypoglycemia should be assumed and tx
initiated
โFollow the "Rule of 15" to tx hypoglycemia
โA blood glucose less than 70 mg/dL is tx by ingesting 15g of a simple
(fast acting) carb, such as 4-6oz of fruit juice or a regular soft drink
โCommercial products such as gels/tablets containing specific amounts of
glucose are convenient for carrying in a purse
โRecheck the blood glucose 15 minutes later
โIf the value is still less than 70, ingest 15g more of carb and recheck again
in 15 minutes
โIf no significant improvement occurs after 2-3 doses of 15g of simple
carb, contact the HCP
โAfter an acute episode of hypoglycemia, have the pt ingest a complex carb
after recovery to prevent repeat hypoglycemia
โInterprofessional care for hypoglycemia:
โDiagnostic assessment:
โHx of hypoglycemia and symptoms
โBlood glucose โ immediately
โManagement
โDetermine cause of hypoglycemia (after correction of condition)
โConscious pt
โHave them eat/drink 15g of quick-acting carb (4-6oz of
regular soda, 5-8 lifesavers, 1 tbsp syrup/honey, 4 tsp jelly,
4- 6 oz orange juice, commercial dextrose products)
โWait 15 min then check blood glucose again
โIf level is still <70, have pt repeat tx of 15g of carb
โOnce glucose level is stable and the next meal is more than
1 hour away, give pt additional food of carbohydrate plus
protein/fat (e.g. crackers with peanut butter/cheese) after
symptoms subside
โGive additional food if pt is engaged in physical
activity regardless of time until next meal
