1. Hyperglycemia/Hypoglycemia
Esther Kihuga, Karen Lee, Lisa Le, Jessica Teng, Rossana Aquino, Jennifer Park, Carmen Tsui, Elizabeth Cheatham, Malina Rowell, Stacey Dao, Tina Nguyen, Farid Abdullah

2. What causes Hypoglycemia?
Insufficient food / delayed meal or snack
Excess insulin or excess oral hypoglycemic agents
Too much physical activity
Too much exercise  using up too much glucose

3. Physical Manifestations of Hypoglycemia
Shakiness/tremors
Nervousness/anxiety
Sweating/clamminess
Hunger
Irritability, confusion, and bizarre behavior
Tachycardia
Headache
Weakness/fatigue
If not treated – can lead to seizures, coma, and death.
Know how to recognize these symptoms early because these symptoms develop quickly and if not treated, can lead to serious complications

4. How to correct hypoglycemia
Administer:
3-4 glucose tablets
1 serving of glucose gel (equal to 15 grams of carbohydrate)
½ cup or 4 ounces of a regular soft drink
1 cup or 8 ounces of milk
5-6 pieces of hard candy
1 tablespoon of sugar or honey
**Amounts varies among individual**
Glucose gel = “cake frosting” but way more expensive and for medical use

5. Nursing implications for hypoglycemia
Assess:
Level of consciousness
Respiratory and circulatory status
Blood glucose
Existence of IV access
Time and amount of insulin doses
Amount of food eaten
Blood glucose check often
What do you do if patient is unconscious? IM glucagon, glucose gel, or IV dextrose (very little!)

6. What Causes Hyperglycemia?
Inadequate administration of insulin/medication – T1DM
Insufficient insulin for body’s demands – T2DM skipping or forgetting insulin/medications
Eating too much
Not enough exercise
Stress from illness – ex: flu and infection
In T1DM, patient may not have given themselves enough insulin
In T2DM, the body is still producing insulin, but it is not enough for the body’s demands
Too much food intake without the adequate amount of insulin

7. Physical manifestations of hyperglycemia
Extreme thirst
Dry or itchy skin
Hunger
Blurred vision
Drowsiness
Infections
Increased urination
Video on symptoms of hyperglycemia
The 3 P’s: Polydipsia, polyphagia, polyuria

8. How to correct hyperglycemia
Insulin therapy
Electrolyte stabilization
Treatment/prevention of long term complications
Main goal is restoration to near normal blood glucose levels

9. Nursing implications for hyperglycemia
Educate patient on signs and symptoms
Assess patient for signs of DKA and infection
Check patient history of diabetes, hyperglycemia, and hypoglycemia
Assessing patient for signs of DKA: fruity smelling breath, n/v, SOB, dry skin, weakness, confusion, coma
Infection signs: fever

10. Any questions?