Welcome to the series, finger-stick blood glucose level.
This is also commonly known as a blood sugar, you may hear that name often.
So we're typically going to get this important piece of diagnostic information
in several different patient conditions but especially our diabetic patients.
So let us look at some important points to keep in mind.
Now, the principles of obtaining the actual level is about the same throughout.
But just know there are several different types of glucose monitors
and there's a lot of variations to this.
So you want to become really familiar with the agency equipment that you have.
Just know also that the equipment used in a hospital
versus the stuff that maybe your patient uses at home is going to be quite a bit different,
and therefore the capabilities and the limitations of your monitor will vary.
Just keep in mind when we're talking about obtaining this,
now the client's order is going to vary quite a bit.
It's going to be relevant to their condition.
Here is a great example of that.
If we're talking about a diabetic patient, for example,
we may obtain this level maybe AC and HS, otherwise know as before meals and at bedtime.
You may also see the order for blood glucose level every 6 hours.
This could be potentially because your patient is on ongoing to feeding on nutritional supplements.
Now, some higher level care like the intensive care unit, we may take this level a lot more often.
So when we're talking about a blood glucose level, it's important to know really critical ranges.
What I'm talking about here is your facility's protocol for what we say is hypo, meaning low
and hyper, meaning high glycemia.
So a high and low blood sugar.
So hypoglycemia, most facilities are going to say that this is the case
when your patient's blood glucose reaches less than 70 mg/dL.
We also define hyperglycemia, most commonly, greater than 140 mg/dL.
Now let's note that the American Diabetes Association is going to define hypoglycemia as less than 54 mg/dL.
They're also going to define severe hypoglycemia of less than 54 mg/dL with symptoms.
Now let's talk about some signs and symptoms of both of those conditions.
So when we're talking about hyperglycemia, meaning an elevated blood glucose,
defined as greater than 140 mg/dL, here are some signs and symptoms that you may see:
such as fatigue, maybe blurred vision, maybe excessive thirst or fruity breath.
So let's just talk about the fruity breath, that's typically meaning that we have blood glucose
in the extremely elevated ranges.
And this could mean the patient's blood glucose is so high, they could be close to going into a coma.
This is an emergency.
Now, some clients may not display symptoms of hyperglycemia
until the blood glucose is extremely high.
Or the patient could also have nausea and vomiting and increased urination.
So just know with typical hyperglycemia, if this is a chronic issue for our diabetic patients.
Now, the patient could be running at maybe 200's (mg/dL), for example
for a long time and not have many of this symptoms or even any at all.
So this is why important glucose monitoring is a great education for your patients who have diabetes.
Now let's look at the flip side of that otherwise known as hypoglycemia.
Now, depending on your agency's protocol, it could be defined as less than 70 (mg/dL)
or here, as less than 54 mg/dL.
Now here's the difference.
When a patient has hypoglycemia, they are much more likely to show symptoms here.
Such as anxiety, just not feeling right, a lot of confusion, some tingling.
The patient may start having diaphoresis or sweating and getting clammy,
tachycardia or fast heart rate, hunger or even the shakes or tremors.
So when you're talking about hypoglycemia, this is typically much scarier for you as a nurse
and has to be treated quickly.