Diabetes and Blood Glucose Levels

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Questions and Answers

What is the normal blood glucose level range?

The normal blood glucose level range is 4-8 mmol/L.

Identify two common signs of hyperglycemia.

Polyuria and Polydipsia are two common signs of hyperglycemia.

How would you educate a patient with T2DM on monitoring their blood glucose levels?

Instruct the patient to use a glucose meter and check their levels consistently, such as before breakfast and dinner.

What immediate actions should be taken for a patient with hyperglycemia?

Immediate actions include administering prescribed insulin and monitoring BGL after administration. Signup and view all the answers

Why is insulin administered to patients with diabetes?

Insulin regulates blood sugar levels and allows glucose to enter cells for energy. Signup and view all the answers

What type of exercises would you recommend for a patient with T2DM and peripheral vascular disease?

Suggest seated exercises like lateral raises and leg lifts that are low-impact and safe for their condition. Signup and view all the answers

What are ketones and why are they concerning?

Ketones are produced by the liver when fat is broken down for energy due to low glucose, and they can cause acidosis. Signup and view all the answers

Identify the healthcare professionals you would refer a diabetic patient to for comprehensive management.

Refer the patient to an endocrinologist, dietitian, podiatrist, physical therapist, and social worker. Signup and view all the answers

Define hypoglycemia and its typical blood glucose range in diabetic patients.

Hypoglycemia is when blood glucose levels fall below the normal range of 4-8 mmol/L. Signup and view all the answers

What does DKA stand for and what patients are likely to experience it?

DKA stands for Diabetic Ketoacidosis, commonly seen in patients with BGL higher than 13 mmol/L. Signup and view all the answers

What are common signs and symptoms of hypoglycemia to look for in a patient?

Look for signs such as shakiness, dizziness, hunger, and confusion if the hypoglycemia is severe. Signup and view all the answers

How would you manage a patient with DKA?

Management includes administering insulin, fluids, and potentially bicarbonate as prescribed. Signup and view all the answers

What immediate actions should be taken for a conscious patient experiencing hypoglycemia?

Administer fast-acting carbohydrates like juice or sugar and evaluate the patient's consciousness level. Signup and view all the answers

What does HHNS stand for and what is a key feature of this condition?

HHNS stands for Hyperosmolar Hyperglycemic State, characterized by high BGL without ketones. Signup and view all the answers

What steps should be followed if a patient is found unconscious due to hypoglycemia?

Call Code Blue or MetCall, ensure airway maintenance, and follow doctor's orders for administration. Signup and view all the answers

How would you monitor a hypoglycemic patient's response to treatment?

Conduct assessments, check vital signs and GCS, monitor blood glucose levels, and document findings. Signup and view all the answers

Study Notes

Blood Glucose Levels

Normal blood glucose level range: 4-8 mmol/L

Hyperglycemia

Common Signs and Symptoms:
- Polyphagia (increased hunger)
- Polydipsia (increased thirst)
- Polyuria (increased urination)
- Nausea and Vomiting (Diabetic Ketoacidosis - DKA)
- Slow wound healing
- Dry mouth
- Dehydration
- Blurred vision
Focused Nursing Assessment:
- Glasgow Coma Scale (GCS)
- Blood Glucose Level (BGL)
- Ketones (if BGL > 13 mmol/L)
- Skin assessment (Peripheral neuropathy)
Immediate Actions:
- Administer prescribed insulin
- Report to RN or NIC if unconscious
- Monitor BGL after insulin administration

Insulin

Insulin regulates blood sugar levels
For type 1 diabetics, it is essential as they cannot produce insulin.
It may be necessary for type 2 diabetics when other treatments fail (oral medications, lifestyle changes).
Insulin allows glucose from the blood to enter cells, providing energy.
Side Effects:
- Redness and swelling at injection site
- Weight gain
- Constipation
- Hypoglycemia

Ketones

The liver produces ketones for energy when there is a lack of glucose.
Ketones are acidic; high levels cause rapid breathing to remove excess acid.
Diabetic Ketoacidosis (DKA):
- Occurs when BGL > 13 mmol/L
- Symptoms: nausea, vomiting, dehydration (due to body trying to remove waste)
DKA Management:
- Administer insulin
- Administer fluids (due to dehydration)
- Administer bicarbonate (as prescribed)
- Monitor potassium levels (fluid administration can dilute potassium)

Hyperosmolar Hyperglycemic State (HHNS)

A dangerous state resulting from high BGL without ketones.
Occurs gradually due to severe dehydration.
Signs and Symptoms:
- Polyuria
- Polydipsia
- Polyphagia
- Dizziness
- Fatigue
- Coma (late stage)
Management:
- Administer insulin
- Administer fluids
- Monitor electrolyte status

### Diabetes Management

Patient Education for T2DM:
- Teach blood glucose monitoring using a glucose meter.
- Encourage consistent monitoring, like before breakfast and dinner.
- Suggest seated exercises like lateral raises and leg lifts (considering peripheral vascular disease).
- Encourage joining diabetes or mental health support groups.

### Patient Referrals

Endocrinologist: Adjust medication
Dietitian: Personalized dietary advice
Podiatrist: Foot health
Physical Therapist: Exercise program development
Social Worker: Support for living alone with a dog

Hypoglycemia

Occurs when blood glucose level is below 4-8 mmol/L.
Can occur in diabetics taking excess insulin, during fasting, or with increased physical activity.
Common Signs and Symptoms:
- Shakiness
- Dizziness
- Hunger
- Confusion (severe)
Factors contributing to hypoglycemia in diabetics:
- Excess insulin
- Increased physical activity
- Malnutrition/starvation

Hypoglycemia Recognition and Management

Recognition Signs and Symptoms:
- Physical symptoms: shakiness, paleness, dizziness
- Confusion, difficulty concentrating, hunger
Immediate Actions:
- Follow hospital policy.
- Evaluate patient consciousness:
  - If conscious and alert: Administer fast-acting carbohydrates (juice, cordial, sugar).
  - If unconscious: Call Code Blue or MetCall, maintain airway, administer prescribed medication.
Safety and Monitoring:
- Conduct assessments (vital signs, GCS).
- Monitor BGL (conscious: every 15 minutes; unconscious: every 5 minutes).
- Document BGL, treatment, and response.

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Description

This quiz covers essential topics related to blood glucose levels, hyperglycemia, and the role of insulin in diabetes management. It includes signs and symptoms of hyperglycemia, nursing assessments, and immediate actions to take. Test your knowledge on how these elements interact in the context of diabetes care.