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