Presentation on theme: "HYPOGLYCEMIA/GLUCAGON®"— Presentation transcript:
1HYPOGLYCEMIA/GLUCAGON® Jennifer Sellers, RN,CDEACH Diabetes Team
2Child will be testing blood sugars: Blood Glucose TestingChild will be testing blood sugars:Before meals2 hours after breakfast/lunchBefore bedtimeAt 2-3 am (for a short time after discharge from the hospital, then as indicated)
3Blood Glucose TestingBlood sugar values should always be recorded on record sheets or log book, need to be communicated to parent/guardian on a regular basisTarget ranges will vary depending on child’s age
4Target Blood Sugar Ranges Below age 5 years:mg/dl5-12 years:mg/dlTeenagers:mg/dl
5The most common reasons for hypoglycemia WHY??The most common reasons for hypoglycemia(low blood sugar) are:Too much insulin administered (questionable carb counting or math error)Extra or prolonged exercise without extra foodMistake in drawing/dialing up insulin dose
6Symptoms of Hypoglycemia headacheirritabilityconfusionsweatingweaknessrapid heart rateshakinesspersonality changes
7Treatment of Hypoglycemia Treat any blood sugar below 70, using Rule of 15For seizure or unconsciousness, use Glucagon Emergency Kit® as prescribed
8RULE OF 15Treat a low blood glucose with 15 grams of fast-acting carbohydrateWait 15 minutes and recheck blood glucoseIf blood glucose is not above 70 mg/dl, then retreat with 15 grams, and recheck in 15 minutesOnce blood glucose is corrected, give a small snack, (15 grams of carbohydrate plus a protein) or the regularly scheduled meal within 30 minutes.If it is a meal time, you must get the blood glucose above 70 before giving the meal/snack.
9Rule of 15: Insulin Pumps For blood sugar 51-70: Follow Rule of 15For blood sugar <50:Start temporary basal (5% or –95%, depending on the pump), for 30 minutesGive 30 grams of fast-acting carbsRecheck in 15 minutes and continue with Rule of 15, if not >70
10Examples of 15 gm Fast Acting Carbohydrate 4 ounces juice or regular soda3 glucose tablets2 pkg Smarties®1 tube glucose gel1 tube cake icing gel3 sugar packets
12Glucagon®Is used for severe hypoglycemia resulting in unconsciousness/seizure activityIs a hormone that stimulates the liver to release stored glucoseGiven either IM/SQ, where insulin injections givenDo not give if the student is able to eat or drinkCommon side effects: headache, nausea, and vomiting
13Glucagon®/Seizure Precautions Lay student on the floor on their side to keep airway openClear the area around him/her of anything hard or sharpDo not try to hold student down or stop movementsLoosen any tight clothing, especially anything around the neckDo not put anything in the mouth
16Glucagon® May take 15-20 minutes for student to regain consciousness Student may not remember any events surrounding the severe low blood suagrBlood sugar could likely rise over 200Headache, nausea, and vomiting are very common side effects
18Recap Check blood sugar for any symptoms of low blood sugar Student must not be left unattended if low blood sugar suspectedIf conscious, treat with Rule of 15For unconsciousness/having a seizure, utilize GlucagonALL low blood sugars need to be relayed to parents for reporting to the Diabetes Team
19Case Scenario 1Student is escorted to your office stating they “don’t feel good.” Symptoms of shaking and sweating noted. Student will be going to lunch in 10 minutes. What are the next steps?
20Case Scenario 1 (cont.) Check blood sugar Follow Rule of 15 Recheck 75Send to lunch, carbs eaten 48 grams with orders for 1:20 gms48/20 = 2.4 = 2 unitsDose for all carbs eaten at lunch
21Case Scenario 2Student is in PE and starts complaining of “feeling low.” The coach calls the nurse, stating the student appears confused and lethargic. When you arrive you note the student is also pale and sweaty. Now what…
22Case Scenario 2 (cont.) Check blood sugar Follow Rule of 15 Repeat The student has 2 more class periods until lunch…
23Case Scenario 2 (cont.)Give student a snack containing 15 grams of complex carbohydrates and proteinSend student back to normal activity and recheck prior to lunch.
24Case Scenario 3You are called to the classroom to find a student with diabetes having a seizure. How do you proceed?
25Case Scenario 3 (cont.) Check blood sugar* Insure safety of student Give Glucagon®Another staff member should contact EMS and student’s parent/guardian*do not withhold emergency treatmentif meter not close by