Short Term Goal For Risk For Unstable Blood Glucose

Managing Glucose Levels In Hospital Patients

Managing glucose levels in hospital patients Author: Stacey A. Seggelke, MS, RN, ACNS-BC, BC-ADM, CDE, Over the last 25 years, more than twice as many patients have been discharged from U.S. hospitals with a diagnosis of diabetes mellitus (DM). In 2006, the number reached an estimated 5.2 million. The increase stems from many factors, including the overall rise in obesity, which parallels the increase in type 2 diabetes. Typically, about 25% of hospital patients have a diagnosis of DM or hyperglycemia during their hospital stay. Historically, managing hyperglycemia in the hospital has been seen as secondary to managing the admitting diagnosis. But a growing body of literature supports targeted glucose control, because hyperglycemia in hospital patients can prolong lengths of stay, increase the infection risk, and raise mortality. This article, which addresses glucose management in hospital patients who arent critically ill, is based largely on guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE). Generally, hyperglycemia in hospital patients is classified as known DM, newly diagnosed DM, or stress hyperglycemia. Known DM applies to patients with preexisting type 1, type 2, or gestational diabetes. Newly diagnosed DM refers to patients newly diagnosed during their hospital stay who meet ADA diagnostic criteria. A hemoglobin A1c (HbA1c) level of 6.5% or higher indicates DM and reflects an average blood glucose (BG) level of 140 mg/dL. The HbA1c test indicates the average BG level over the preceding 2 to 3 months; an elevated HbA1c level indicates the patients BG level was high before admission. Hospital patients with HbA1c levels of 6.5% or higher usually are classified as newly diagnosed, even though th Continue reading >>

Glucose

Synonym/Acronym: Blood sugar, fasting blood sugar (FBS), postprandial glucose, 2-hr PC (post cibum). Common Use: To assist in the diagnosis of diabetes and to evaluate disorders of carbohydrate metabolism such as malabsorption syndrome. Specimen: Serum collected in a gold-, red-, or red/gray-top tube, although plasma is recommended for diagnosis of diabetes. Plasma collected in a gray-top (sodium fluoride) or a green-top (heparin) tube. Normal Findings: (Method: Spectrophotometry) Age Conventional Units SI Units (Conventional Units × 0.0555) Fasting Cord blood 45–96 mg/dL 2.5–5.3 mmol/L Premature infant 20–80 mg/dL 1.1–4.4 mmol/L Newborn 2 d–2 yr 30–100 mg/dL 1.7–5.6 mmol/L Child 60–100 mg/dL 3.3–5.6 mmol/L Adult-older adult Less than 100 mg/dL Less than 5.6 mmol/L Prediabetes or impaired fasting glucose 100–125 mg/dL 5.6–6.9 mmol/L 2-hr postprandial 65–139 mg/dL 3.6–7.7 mmol/L Prediabetes or impaired 2-hr sample 140–199 mg/dL 7.8–11 mmol/L Random Less than 200 mg/dL Less than 11.1 mmol/L The American Diabetes Association and National Institute of Diabetes and Digestive and Kidney Diseases consider a confirmed fasting blood glucose greater than 126 mg/dL to be consistent with a diagnosis of diabetes. Values tend to increase in older adults. Glucose, a simple six-carbon sugar (monosaccharide), enters the diet as part of the sugars sucrose, lactose, and maltose and from the complex polysaccharide, dietary starch. The body acquires most of its energy from the oxidative metabolism of glucose. Excess glucose is stored in the liver or in muscle tissue as glycogen. Glucose levels in plasma (one of the components of blood) are generally 10% to 15% higher than glucose measurements in whole blood (and even more after eating). This is important becau Continue reading >>

Maternal Nursing Care Plan For Risk For Unstable Blood Glucose

The goal would be successfully met if the client can verbalize 5 self-care actions to take if blood glucose is too high or too low on xxxxxx. If the client can not verbalize 5 self-care actions the goal would not be successfully met. If the client either verbalize having kept a blood glucose diary, or can present a blood glucose diary this intervention would be successful. If not, the intervention would be unsuccessful. The intervention would be successful if the client verbalizes having consumed extra carbs or glucose before exercising. If the client can not do this the intervention is not successful. The intervention would be successful if the client verbalizes continuing insulin therapy. If the client can not do this the intervention is not successful. 4,700 Med Surg Nursing review flash cards, download now and ace your exams About catholic charities USA. (2009). Retrieved October 1, 2009, from Ackley, B. & Ladwig, G. (2008). Nursing diagnosis handbook: An evidence-based guide to planning care. St. A womans choice resource center. (2006). Retrieved October 1, 2009, from Disaster assistance. (2009). Retrieved October 1, 2009, from Disaster assistance available from FEMA. (2009). Retrieved October 1, 2009, from assistance/process/assistance.shtm#1 Get assistance. (2009). Retrieved October 1, 2009, from d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=6cde1a53f1c37110VgnVCM1000003481a10aRCRD& Necoles place. (2006). Retrieved October 1, 2009, from Prepare for disaster. (2009). Retrieved October 1, 2009, from Prepare your family and home. (2009). Retrieved October 1, 2009, from http:// www.redcross.org/portal/ site/en/menuitem.d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=72c51a53f1c37110VgnVCM100000 Ricci, S.S. & Kyle, T. (2009). Maternity and pediatric nursing. China: Wolters Continue reading >>

Nanda Nursing Interventions

3 Nursing Care Plan Diabetes Mellitus - Diagnosis, Interventions and Rational 1. Nursing Diagnosis : Fluid Volume Deficit related to osmotic diuresis. Demonstrate adequate hydration evidenced by stable vital signs, palpable peripheral pulse, skin turgor and capillary refill well, individually appropriate urinary output, and electrolyte levels within normal limits. Rational: hypovolemia can be manifested by hypotension and tachycardia. 2.) Assess peripheral pulses, capillary refill, skin turgor, and mucous membranes. Rational: This is an indicator of the level of dehydration, or an adequate circulating volume. 3.) Monitor input and output, record the specific gravity of urine. Rational: To provide estimates of the need for fluid replacement, renal function, and effectiveness of the therapy given. Rational: To provide the best assessment of fluid status of ongoing and further to provide a replacement fluid. Rational: The type and amount of liquid depends on the degree of lack of fluids and the response of individual patients. 2. Nursing Diagnosis : Imbalanced Nutrition Less than Body Requirments related to insufficiency of insulin, decreased oral input. Digest the amount of calories / nutrients right 1.) Determine the patient's diet and eating patterns and compared with food that can be spent by the patient. Rationale: Identify deficiencies and deviations from the therapeutic needs. 2.) Weigh weight per day or as indicated. Rational: Assessing an adequate food intake (including absorption and utilization). 3.) Identification of preferred food / desired include the needs of ethnic / cultural. Rational: If the patient's food preferences can be included in meal planning, this cooperation can be pursued after discharge. 4.) Involve patients in planning the family meal as ind Continue reading >>

Tight Control Of Type 1 Diabetes: Recommendations For Patients

STEPHEN HAVAS, M.D., M.P.H., M.S., American Medical Association, Chicago, Illinois THOMAS DONNER, M.D., University of Maryland School of Medicine, Baltimore, Maryland Am Fam Physician. 2006 Sep 15;74(6):971-978. Patient information: See related handout on type 1 diabetes, written by the authors of this article. Tight control of blood glucose levels and risk factors for cardiovascular disease (e.g., hypertension, hypercholesterolemia) can substantially reduce the incidence of microvascular and macrovascular complications from type 1 diabetes. Physicians play an important role in helping patients make essential lifestyle changes to reduce the risk of these complications. Key recommendations that family physicians can give patients to optimize their outcomes include: take control of daily decisions regarding your health, focus on preventing and controlling risk factors for cardiovascular disease, tightly control your blood glucose level, be cognizant of potentially inaccurate blood glucose test results, use physiologic insulin replacement regimens, and learn how to manage and prevent hypoglycemia. Randomized clinical trials1–5 have demonstrated that tight control of blood glucose levels reduces the risk of microvascular and macrovascular complications in patients with type 1 diabetes; this is not true for patients with type 2 diabetes. Although many patients with type 1 diabetes may benefit from tightly controlling their blood glucose levels,3 few do so.6 The Diabetes Control and Complications Trial (DCCT)4 showed that, compared with conventional therapy, intensive therapy significantly reduced the risk of retinopathy progression (4.7 versus 1.2 per 100 patient-years, number needed to treat [NNT] = three for 10 years) and clinical neuropathy (9.8 versus 3.1 per 100 patie Continue reading >>

Diabetes - Long-term Effects

On this page: Diabetes is a condition in which there is too much glucose (a type of sugar) in the blood. Over time, high blood glucose levels can damage the body's organs. Possible complications include damage to large (macrovascular) and small (microvascular) blood vessels, which can lead to heart attack, stroke, and problems with the kidneys, eyes, gums, feet and nerves. Reducing risk of diabetes complications The good news is that the risk of most diabetes-related complications can be reduced by keeping blood pressure, blood glucose and cholesterol levels within recommended range. Also, being a healthy weight, eating healthily, reducing alcohol intake, and not smoking will help reduce your risk. Regular check-ups and screening are important to pick up any problems early Diabetes and healthy eating If you have diabetes it’s important to include a wide variety of nutritious and healthy foods in your diet, and to avoid snacking on sugary foods. Eating healthy foods can help control your blood glucose and cholesterol levels, and your blood pressure. Enjoy a variety of foods from each food group – be sure to include foods high in fibre and low in fat, and reduce your salt intake. It’s helpful to consult with a dietitian to review your current eating plan and provide a guide about food choices and food quantities. Alcohol intake and diabetes Limit alcohol intake. If you drink alcohol, have no more than two standard drinks per day. If you are pregnant or considering pregnancy or are breastfeeding, then zero alcohol intake is recommended. Diabetes and healthy weight If you are overweight, even losing a small amount of weight, especially round the abdomen, helps lower your blood pressure, blood glucose and cholesterol levels. It can be daunting trying to lose weight, so Continue reading >>

Diabetes

Sort Type 2 DM: Etiology & Pathophysiology -Pancreas continues to produce some endogenous insulin -Insulin insufficient or poorly utilized -Multiple etiologic factors -Obesity is greatest risk factor -Genetic component increases insulin resistance and obesity -Gradual onset -Hyperglycemia may go many years without being detected -Many times discovered with routine laboratory testing Prediabetes -Individuals at risk for type 2 diabetes -Impaired glucose intolerance (IGT) -Two-hour oral glucose tolerance test (OGTT): 140 to 199 mg/dL-Impaired fasting glucose (IFG) -Fasting glucose level: 100 to 125 mg/dL -Asymptomatic but long-term damage already occurring -Patient teaching important -Undergo screening -Manage risk factors -Monitor for symptoms of diabetes -Maintain healthy weight, exercise, healthy diet Collaborative Care -Goals of diabetes management -Decrease symptoms -Promote well-being -Prevent acute complications -Delay onset and progression of long-term complications -Need to maintain blood glucose levels as near to normal as possible Patient teaching -Nutritional therapy -Drug therapy -Exercise -Self-monitoring of blood glucose -Diet, exercise, and weight loss may be sufficient for patients with type 2 diabetes -All patients with type 1 require insulin Mealtime Insulin (Bolus) Insulin preparations -Rapid-acting (bolus) --Lispro, aspart, glulisine -Onset of action 15 minutes -Injected within 15 minutes of mealtime Short-acting (bolus) -Regular with onset of action 30 to 60 minutes -Injected 30 to 45 minutes before meal -Onset of action 30 to 60 minutes (Basal) Background Insulin -Used to control glucose levels in between meals and overnight Long-acting (basal) -Insulin glargine (Lantus) and detemir (Levemir)-Released steadily and continuously with no peak action -A Continue reading >>

Nursing Care Plan For Diabetes

Diabetes is really prevalent. Just recall all the patients you saw today and theres probably a handful of them who are diabetic. According to the National Center for Chronic Disease Prevention and Health PromotionDivision of Diabetes Translation, up to 30.3 million people in the United States have diabetes. Because of how prevalent it is, nurses need to be highly knowledgeable and skilled when it comes to educating and caring for their patients. That includes preparing the right nursing care plan for diabetes. Diabetes ordiabetes mellitusis a metabolic disease where blood glucose levels are abnormally high. Symptoms of high blood glucose levels include: In general, there are three types of diabetes and each one varies in terms of treatment and management. Type 1 diabetes is also called insulin-dependent and juvenile-onset diabetes. This type of diabetes often begins early in childhood. Its an autoimmune disorder where the bodys immune system attacks its own pancreas, inhibiting its capacity to produce insulin. Type 2 diabetes accounts for the 95% of diabetes cases in the US. Onset is usually late in adulthood. It happens when the pancreas is unable to produce adequate insulin to meet the bodys needs or when the bodys cells become resistant to it. Type 2 diabetes can be managed with lifestyle and diet changes as well as intake of oral hypoglycemic agents (OHAs). Gestational diabetes is characterized by pregnancy-induced insulin resistance. It affects roughly 2% to 10% of pregnancies. Diabetic patients need complex nursing care. Here are some of the most important NCPs for diabetes: 1. Deficient knowledge regarding disease process, treatment, and individual care needs verbal statements of concerns or misconceptions improper or inadequate follow-through of instructions de Continue reading >>

Hyperglycemia | Nurse Teachings

Patient was instructed to drink more water. Water helps remove the excess glucose from your urine and helps you avoid dehydration. Exercise more. Exercise will help to lower your blood glucose, (blood glucose over 300 mg/dL do NOT exercise). Change your eating habits. Make sure you are following your meal plan, exercise program and medicine schedule. Instructed patient to eat healthy food, as people with diabetes do not need special foods. The foods on your diabetes eating plan are the same foods that are good for everyone in your family. Try to eat foods that are low in fat, salt, and sugar and high in fiber such as beans, fruits and vegetables, and grains. Eating right will help you reach and stay at a weight that is good for your body, keep your blood sugar in a good range and prevent heart and blood vessel disease. Instructed to patient exercise is good for those with diabetes. Walking, you can even get exercise when you clean house or work in your garden. Exercise is especially good for people with diabetes because exercise helps keep weight down. Exercise helps insulin work better to lower blood sugar, exercise is good for your heart and lungs. Exercise after eating, not before, test your blood sugar before, during, and after exercising. Don't exercise when your blood sugar is over 240, avoid exercise right before you go to sleep, because it could cause low blood sugar during the night. Patient was instructed If you eat more food than is balanced with your physical activity and, in some cases, diabetes medicines, your blood glucose level may rise above your goal range. Carbohydrate-containing foods directly affect your blood glucose level after eating, so reviewing the amount of carbohydrate in your meals and snacks may be helpful in determining the cause of hype Continue reading >>

Laboratory Testing For Diabetes Diagnosis And Management

Laboratory Testing for Diabetes Diagnosis and Management This Test Guide discusses the use of laboratory tests ( Table 1 ) for diagnosing diabetes mellitus and monitoring glycemic control in individuals with diabetes. Tools for diagnosing diabetes mellitus include fasting plasma glucose (FPG) measurement, oral glucose tolerance tests (OGTT), and standardized hemoglobin A1c (HbA1c) assays ( Table 2 ). FPG and OGTT tests are sensitive but measure glucose levels only in the short term, require fasting or glucose loading, and give variable results during stress and illness. 1 In contrast, HbA1c assays reliably estimate average glucose levels over a longer term (2 to 3 months), do not require fasting or glucose loading, and have less variability during stress and illness. 1, 2 In addition, HbA1c assays are more specific for identifying individuals at increased risk for diabetes. 1 Clinically significant glucose and HbA1c levels are shown in Table 2 . 1 The American Diabetes Association (ADA) recommends using these values for diagnosing diabetes and increased diabetes risk (prediabetes). Following a diagnosis of diabetes, a combination of laboratory and clinical tests can be used to monitor blood glucose control, detect onset and progression of diabetic complications, and predict treatment response. Table 3 shows the recommended testing frequency and target results for these tests. Different laboratory tests are available for monitoring blood glucose control over the short, long, and intermediate term to help evaluate the effectiveness of a management plan. 1 Self-monitoring of blood glucose (SMBG) is useful for tracking short-term treatment responses in insulin-treated patients, but its usefulness is less clear in noninsulin-treated patients. 1 By contrast, the long-term Hb Continue reading >>

Type 1 Diabetes Complications

Type 1 diabetes is complicated—and if you don’t manage it properly, there are complications, both short-term and long-term. “If you don’t manage it properly” is an important if statement: by carefully managing your blood glucose levels, you can stave off or prevent the short- and long-term complications. And if you’ve already developed diabetes complications, controlling your blood glucose levels can help you manage the symptoms and prevent further damage. Diabetes complications are all related to poor blood glucose control, so you must work carefully with your doctor and diabetes team to correctly manage your blood sugar (or your child’s blood sugar). Short-term Diabetes Complications Hypoglycemia: Hypoglycemia is low blood glucose (blood sugar). It develops when there’s too much insulin—meaning that you’ve taken (or given your child) too much insulin or that you haven’t properly planned insulin around meals or exercise. Other possible causes of hypoglycemia include certain medications (aspirin, for example, lowers the blood glucose level if you take a dose of more than 81mg) and alcohol (alcohol keeps the liver from releasing glucose). There are three levels of hypoglycemia, depending on how low the blood glucose level has dropped: mild, moderate, and severe. If you treat hypoglycemia when it’s in the mild or moderate stages, then you can prevent far more serious problems; severe hypoglycemia can cause a coma and even death (although very, very rarely). The signs and symptoms of low blood glucose are usually easy to recognize: Rapid heartbeat Sweating Paleness of skin Anxiety Numbness in fingers, toes, and lips Sleepiness Confusion Headache Slurred speech For more information about hypoglycemia and how to treat it, please read our article on hy Continue reading >>

Risk For Unstable Blood Glucose Level Care Plan Writing Services

Risk for Unstable Blood Glucose Level Care Plan The risk of unstable blood glucose level is to be vulnerable to a variation of the blood glucose/sugar levels from their normal range. Glucose is just one type of the sugars that humans among others such as fructose from the fruits and lactose from milk. The body converts these other kinds of sugars into glucose for use as energy. Unstable blood glucose can be elevated (hyperglycemia) causing disorders such as diabetes or low (hypoglycemia). Risk for Unstable Blood Glucose Level Care Plan Diagnosis A caregiver who thinks that a patient has a risk of unstable blood glucose level can determine its existence by checking the presence of these risk factors. Less than recommended average daily activity Inadequate or non-adherence to diabetes management Risk for Unstable Blood Glucose Level Care Plan Goals and outcomes A care plan should have these goals for helping the patient to achieve outcomes that can eliminate or manage the condition for improved life. Maintain less than 180 my/Dl glucose reading Stay healthy without signs of hyperglycemia or hypoglycemia Increase knowledge of how to and importance of maintaining blood glucose levels at normal levels. Risk for Unstable Blood Glucose Level Care Plan Assessments and rationales Assessment is a significant step in identifying the potential problems that could alter blood glucose levels. The following assessments assist the caregivers in developing a care plan that contributes to addressing the condition and handling conflicts that might appear during the nursing care. Assess the patient for signs of hyperglycemia: Presence of hyperglycemia signals an occurrence of diabetes, and this requires immediate intervention. Assess the patient for signs of hypoglycemia: Lets the nurse t Continue reading >>

Risk For Unstable Blood Glucose Level Nursing Diagnosis And Nursing Care Plan

Risk for Unstable Blood Glucose Level Care Plan Want create site? Find Free WordPress Themes and plugins. Risk for Unstable Blood Glucose Level Nursing Diagnosis and Nursing Care Plan Risk for unstable blood glucose level is the presence of possible variation of blood glucose/sugar levels from the normal range. Glucose is one kind of sugar which the body utilizes most and used it a source of energy. Serum glucose is transported from the intestines or liver to body cells via the bloodstreamand is made available for cell absorption via the hormone insulin which is a hormone produced by the body found in the pancreas. Sometimes due to different causative factors, glucose levels is beyond normal ranges. Hyperglycemia or the elevated blood glucose levels may occur in a variety of clinical situations.In the occurrence of increase blood glucose level at a constant basis, it detects the presence of Diabetes Mellitus which is a disorder that causes inability to normalize the blood glucose levels of the body. There are certain treatments for this DM but there are instances that it can produce hypoglycemia which is the opposite of Diabetes. Patients with DM are at risk of having unstable blood glucose levels. They need to maintain the blood glucose levels at all times. It should not be above or below normal ranges because it will cause certain symptoms. An important part of managing blood glucose levels, as well as the overall health of a person, is maintaining a healthy weight through a healthy diet and exercise plan. Diabetes needs a strict management of the disease process to prevent several complications thereafter. Risk Factorsfor unstable blood glucose level Average daily physical activity is less than recommended for gender and age Insufficient knowledge of disease managem Continue reading >>

Risk For Unstable Blood Glucose Levels Because If The

Risk for unstable blood glucose levels because if the BS is too high or low the Risk for unstable blood glucose levels because if the 100% (4) 4 out of 4 people found this document helpful This preview shows page 13 - 17 out of 18 pages. Risk for unstable blood glucose levels because if the BS is too high or low the bodys ability to function will be completely altered(Transferthisnursingdiagnosistothenextpagetoprocess) DETERMINEANDPROCESSTHEONEPRIORITYDIAGNOSIS(UsethePriorityClusteronpreviouspage.)NursingDXandSupportiveDataShortTermGoalsandNursingInterventionsScientificRationaleOverallEvaluationandRevisionsIncludingproblems,etiologyanddefiningcharacteristics(useAckley)RiskforunstablebloodglucoselevelsEtiology-Thebodyisunabletoreducetheamountofinsulininthebodytostophypoglycemiafromoccurring.Thebodyisunabletoproduceenoughinsulintodecreaseglucoselevelsandpreventhyperglycemia.Characteristics:Bloodglucosehigherthan140Bloodglucoselessthan60blurredvision,impairedthinking,andconsciousness,confusion,seizures,andcomahighlevelsofsugarintheurineGoal:PatientwillmaintainBSlevellessthanorequalto140,andgreaterthanorequalto60PatientwilltakeinsulinasprescribedPatientwillfollowconsistentcarbdietPatientwillreporthypoglycemiaandhyperglycemiaPatientwillbeawareofsnackavailabilityPatientwillverbalizeunderstandingofDMcareInterventions:1.Checkbloodglucoseq4hrs2.AdministerinsulinMonitorforS/sxofhighandlowbloodsugar3.Drawlabs4.Assistpatientwithmakinghealthiermeal/snackchoices1.WillmonitorpatientbloodglucoselevelstopreventhighorlowBS2.Willallowthebodytocontroltheamountofglucoseinthebody3.Topreventthepatientfromgoingintoahypoglycemicorhyperglycemicstate4.TohelpthepatientunderstandDMcareandencourageCCdiet.Revisions:Thispatientisabletomovearound.Hermobilitywasrecentlylimitedbyhypoglycemiaandarecentfa Continue reading >>

Nursing Care Plan For Diabetes (and Diagnosis), High Blood Sugar, Hyperglycemia, Dka, Diabetic Ketoacidosis And Fluid Electrolytes Imbalance

Looking for a nursing care plan for diabetes? This nursing care plan and interventions are for thefollowing conditions: Diabetes, High Blood Sugar, Hyperglycemia, DKA, Diabetic Ketoacidosis, and Fluid and Electrolytes Imbalance. What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan? This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions. Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan. Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care. Nursing Care Plan for: Diabetes, High Blood Sugar, Hyperglycemia, DKA, Diabetic Ketoacidosis, Fluid and Electrolytes Imbalance. If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan. Scenario: A 38 year old male presents to the ER. He states he has been having blurry vision, extreme thirst, and frequent urination since last Sunday night after he attended a Super Bowl Party. It is now Tuesday. He stated that since yesterday morning he has been vomiting. Pt states he has been a type 1 diabetic since he was 5 years old. He states he finds being a diabetic an inconvenie Continue reading >>