Hypoglycemia Nursing Diagnosis
Hypoglycemia is the general term for any pathology involving clinical signs and laboratory signs of lack of glucose (and the transferor resurge, but that we will know after).
Circumstances occurred:
- DT1: Poor adherence, poor understanding (insulin to accommodate the pre prandial blood sugar, with meals provided, if sport after) skip a meal, insulin if taken too early basal bolus doses maladaptive if an intercurrent disease (infection, stress ...)
- DT2: sulfa, poor compliance
Acute-Alcoholization
- Pancreatic Damage: chronic pancreatitis, pancreatic cancer ...
- Another endocrine disorder: Insulinoma, adrenal insufficiency, congenital adrenal hypertrophy, Block 21 hydroxylase enzyme, Cushing disease, acromegaly
- Hepatic insufficiency
- Iatrogenic: Quinine, B, hidden Taking insulin / sulfonylurea
- Genetics: Tuner, T21
- And especially IDIOPATHIC + + + or under nutrition
- Another stuff probably
Adrenergic sweat, tachycardia, palpitation, tremor, heat. Not present if Bbloquants, Hypo repeatedly, Taking insulin for a long time, autonomic neuropathy in diabetics.
Neuro leukopenia: Hunger and painful stomach cramps, paraesthesia, cold, confusion, diplopia, epileptic fit, max coma
Hypoglycemic coma: coma without localizing sign restless, sweating + + +, pyramidal signs (bilateral Babinski, or at least I know more)
Biological signs
Glucose-venous (not capillary) <0.50 g / l (I know in mM) in the nondiabetic, <0.60 g / l in diabetic. What to do If adrenergic signs: fast + slow sugar, make the person sit + / - feet up, ECG differential diagnosis. If signs neurogly copenic: IM glucagon injection or IVD 2ampoules G30%. Emergency hospitalization. Release of the upper airway, recovery position, scope, constants, two large bore intravenous lines. Dosing insulin + C peptide (a marker of endogenous insulin synthesis, helps flush out cheaters which take insulin small hidden - psychiatrist and hospital staff whose IDE + +)
Stopping all hypoglycemic drugs, whether oral anti diabetic stop and put on insulin.
Infusion G10%
Glucose monitoring every four hours + constants
If coma, but ditto sheave emergency hospitalization + / - measures to bedridden (preventing bedsores ...)
Diagnosis after treatment:
Diabetes = plasma glucose (not hair)> 1.26 g / l fasting on two samples at two different times, practice or> 2 g / l at any time day.
HBAIC monitoring (target <7%)
OGTT for etiological confirmation: functional or organic hypoglycemia (insulinoma + +)
I pass on all supported complications of diabetes.
Prevention: If the patient is diabetic.
Reversal of diabetes education:
-Measure's lifestyle modifications + + +: Sport 3x30/sem, balanced diet 5fruits vegetables / day, 50% carbohydrate, 30% lipid (1/3saturée, 1/3polyinsaturée, 1/3monoinsaturée) 20% protein, avoid erosion, three meals / day, avoid food's high glycemic index (soda. .) taken alone, avoiding alcohol (if + + + + metformin).
CAUTION: DO NOT ALLOW FOR FOOD! Everything is permitted but in moderation.
- Observance: Do not stop treatment, do not self medicate)
- Injection techniques: deep SC, change of the site to avoid lipodystrophy ...
- Information: about emergency situations, know the risk behavior, recognize the signs, note in his notebook the dextro and injections, tell the family measures glucagon injections if needed ...
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