Nursing 5263: Hypoglycemia and
Hyperglycemia
Presented by: Excalibur Group Daphney Jacques, Bridgette Jenkins, Opal Jobson-Cudjoe , Kelly miller
Objectives
Distinguish between normal and abnormal blood glucose levels based on patient population
Classify the different diagnosis associated with hypoglycemia/hyperglycemia based on patient age
Compare the common causes of hypoglycemia/hyperglycemia based on patient population
Objectives
Formulate the appropriate interventions for hypoglycemia/hyperglycemia management based on patient population
Differentiate between the different medications used to manage the hypoglycemic/hyperglycemic patient.
Predict immediate complications of hypoglycemia/hyperglycemia
Objectives
State potential long term complications of uncontrolled blood sugar levels
Determine the appropriate educational strategies to prevent hypoglycemia/hyperglycemia
Adolescents and young adults Diabetes is one of the most chronic
conditions affecting young people ages 13- 20 years old. Adolescence is a period of rapid biological change accompanied by increasing physical, cognitive, and emotional maturity. There is a struggle for independence from parents as they try to find their own identity
Type 1 diabetes is predominantly an autoimmune disease, in which the immune system forms antibodies that destroy the beta cells in the pancreas
The diagnosis of type 1 diabetes in adolescents is usually straight-forward and requires little or no specialized testing
Adolescents and young adults
Adolescents and young adults with type 1 diabetes present with a several-week history of polyuria polydipsia, polyphagia, and weight loss, with hyperglycemia, glycosuria, ketonemia, and ketonuria (Silverstein et al., 2005)
The American Diabetes Association suggests that the A1C should be less than 7%
Normal blood is between 70 and 120 mg/ dL
Hypoglycemia Hypoglycemia refers to abnormally
low blood glucose levels (typically less than 70 mg/dl)
Early symptoms include shakiness, dizziness, hunger, headache, lightheadedness, moodiness, pallor, and confusion
Adolescents with type 1 diabetes have poorer glycemic control which results in more hypoglycemic episodes
The most common causes of hypoglycemia is insulin omission, failure to monitor blood sugar, increased physical activity and inappropriate meal plan
Management of Hypoglycemia
Hypoglycemia can be treated by giving absorbable sugar orally in the form of fruit juice, milk, regular (not diet) soda, glucose tablets, or glucose gel(15 grams of carbohydrate) and glucagon for severe hypoglycemia if the individual passes out
Prevention of Hypoglycemia The prevention of diabetes can be
accomplished through self monitoring of blood glucose, individualized meal planning, flexible insulin regimens, checking blood glucose before and after sports, exercise, or other physical activity
Parents guidance and supervision in helping to achieve autonomy and self confidence
Recommended blood sugar checks four times a day
Refrain from drinking alcohol
Test blood sugar before driving and every two hours while driving
Hyperglycemia
Hyperglycemia refers to the condition of having a high level of glucose in the bloodstream( greater than 250mg/dl). This occurs when the body does not have enough insulin
Symptoms include blurry vision, dry mouth, thirst, increased urination, tiredness, coma and death may occur for blood sugar is over 600
Management of Hyperglycemia
Hyperglycemia is treated by giving insulin as prescribed by the doctor
Drinking lots of water
Severe hyperglycemia is a medical emergency and it must be treated immediately with IV (intravenous) fluids and insulin
Prevention of Hyperglycemia
Eat a healthy diet as recommended by healthcare provider
Exercise according to provider's recommendation
Take medicine exactly as directed by healthcare provider
Check blood sugar per provider’s recommendation
Complications of hyperglycemia
Diabetic Ketoacidosis (DKA) : Blood glucose is more than 300 mg/dl resulting in an accumulation of ketones in the blood
Psychiatric Disorders : Adolescents with frequent recurrent of DKA should be screened for psychiatric disorders (Silverstein et al.,2005)
Eating Disorders: High risk for bulimia and anorexia
Note: Anyone experiencing any of the complications should contact their primary care physician
References
Janet Silverstein, Georgeanna Klingensmith, Kenneth Copeland, Leslie Plotnick, & et al. (2005). Care of Children and Adolescents With Type 1 Diabetes: A statement of the American Diabetes Association. Diabetes Care, 28(1), 186-212. Retrieved July 23, 2009, from ProQuest Nursing & Allied Health Source.
Anonymous, . Diabetes Care in the School and Day Care Setting. (2009). Diabetes Care: American Diabetes Association Clinical Practice..., 32(1), S68-72. Retrieved July 22, 2009, from ProQuest Nursing & Allied Health Source