Adult non-pregnant
Hypoglycemia
(Tolerating PO)
Hypoglycemia
(Tolerating PO)
When do you activate the Hypoglycemia protocol?
What is BG <70 mg/dL
What is the first step you take when the glucometer reads capillary blood glucose result <70 mg/dL
What is RE-CHECK capillary BG to confirm <70mg/dL
What is the inpatient blood glucose goal/target?
•The inpatient blood glucose goal is 100-180mg/dL
•The patient’s medication regimen should be re-evaluated if glucose is <100 or >180
The immediate repeat POCT BG result is 64 mg/dL. After activating the PO treatment order, you treat the patient with 4 oz of apple juice. What is your next step?
Repeat the POCT BG in 15 to 30 minutes
The immediate repeat POCT BG result is 64 mg/dL. What is your next step?
Activate the order and give 12.5 grams of D50% IVP STAT or 12.5 gm (125ml) of D10% infused over 15min
After an episode of hypoglycemia (BG < 70 mg/dL) is resolved, what documentation should be added to the chart?
•Always write a Provider Contact Note (Hypoglycemia Event) in the eMAR
•Fill in what provider was notified, time of notification, signs and symptoms patient had, type of diabetes, contributing factors and amount and type of any oral treatment administered
You repeat the Accuchek BG 15 minutes after treatment. The result is BG = 60 mg/dL. What is your next step?
Repeat rule of 15 treatment: treat the patient again with 15 grams fast acting carbs and repeat the BG in 15 mins.
After administering 12.5 grams of D50% IVP STAT, what is your next action?
1. Start D5W @ 100mL/hr (Activate Order or Call Provider for Order)
•If pt on fluid restriction consider D10W @ 50mL/hr or D20% @ 25ml/hr (D20% may only be infused via a central line in ICU per prescriber)
2. Recheck Accuchek BG in 15 minutes
What hyperglycemia BG reading requires the nurse to contact the prescriber to inform them of hyperglycemia?
An Accuchek BG ≥ 250 mg/dL triggers the nurse to contact the provider on first occurrence
You repeat the Accuchek BG 15 minutes after treatment. The result is BG = 63 mg/dL. What is your next step?
Activate order and start D5W at 50mL/hr and CALL PROVIDER. Recheck Accuchek BG every 15 minutes until BG is >100 mg/dL. Document episode in Provider Contact Note (Hypoglycemia event).
After starting the patient on D5W @ 100mL/hr, you repeat the Accuchek BG in 15 minutes. The repeat BG is 83mg/dL. What is your next action?
Activate the order and give 25 grams of D50% IVP STAT or 25 gm (250ml) of D10% infused over 20 minutes. Repeat the Accuchek BG in 15 minutes.
If an Accuchek BG result is > 400 mg/dL, what is the next action to take?
•Re clean pt finger with alcohol, wait for it to dry completely
•Repeat the Accuchek BG to verify > 400 mg/dL
•Treat with insulin per order and contact prescriber for further orders
•If result is “HI”, obtain STAT laboratory blood glucose to confirm level
What is the PO treatment if a patient is Responsive and ABLE to eat
15 gm of fast acting carbohydrate ex(glucose gel (1 tube) or 4oz juice or 6oz regular sod
After giving 25 grams of D50% IVP STAT, you repeat the Accuchek BG in 15 minutes. The repeat BG is 108mg/dL. What is your next action?
1.Maintain D5W at 100mL/hr.
2.Document episode in Provider Contact Note (Hypoglycemia Event)
3.Call Provider to re-evaluate plan of care/medication orders to prevent recurrent hypoglycemia moving forward.
What is the code word for this station?
Dedication