Anything over 120 is considered to be high dx bg 250

* anything over 120 is considered to be high
 Dx BG > 250 mg/dL
 DKA BG > 330 mg/dL
 S/S:
 Polyuria
 Polyphagia
 Polydipsia
 Dehydration
 Fatigue
 Fruity odor (breath – DKA)
 Kussmaul breathing
 Weight loss
 Poor wound healing
 Hypoglycemia Management:
o Mechanism:

Endocrine Notes
 Brain secretes growth hormone (GH) which stimulates liver
 Pancreas secretes glucagon which stimulates the liver
 Thyroid secretes thyroxine which stimulates the liver
 Adrenals secretes epinephrine and medulla/cortex secrete cortisone which
stimulates the liver
 Glucagon, GH, Thyroxine, Cortisone, Epinephrine stimulate the liver to produce
glucose which raise blood sugar along with muscles producing glucose as well
 Thyroxine and epinephrine stimulate the muscles to produce glucose
o Any bloody sugar > 60 mg/dL
o Dangerous condition because glucose is major source of energy for the brain
o Can occur:
 If too much insulin is given
 Not enough food is eaten
 Excessive exercise
o S/S:
 Shaky (tremors)
 Tachycardia
 Sweating (diaphoresis)
 Abnormal behavior
 Dizziness
 Hungry
 Visual changes
 Weakness
 HA
 Irritability
 Seizure (convulsions)
 Loss of consciousness
 Confusion
 Anxiety
o Tx:
 Start with simple carbohydrate (or glucagon, if severe ), then complex carbs &
proteins (cracker, peanut butter, milk)
 Mildly low: give carbohydrate (milk), protein snack
 Moderately low: give fast sugar (fruit juice, frosting), then complex carb and
protein
 COLD AND CLAMMY NEEDS MORE CANDY!!!!!!
o Glucagon Emergency Kit:
 Severely low: BS < 90 mg/dL AND patient is unconscious and/or possibly having
seizure
 Treatment:
 Place patient on side
 Maintain and open airway
 Administer glucagon injection IM in the thigh
 Call 911!
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 Hyperglycemia Management:
o BS > 120 mg/dL should be considered high

Endocrine Notes
o Dx BS > 250 mg/dL
o S/S:
 Polydipsia
 Polyuria
 Polyphagia
 Dry skin
 Visual changes
 Drowsy
 Nausea
 Kussmaul breathing
o Check urine for ketones if blood sugar is > 240 mg/dL
 If negative, trace or small ketones are present then continue to drink clear sugar-
free fluids
 If moderate – large ketones are present, extra fast acting insulin will need to be
given
o Tx:
 IVF Fluid
 Insulin
 Possible glucagon
 Possible oral medications
 Exercise:
o Regularly
o Hypoglycemic risk
o Don’t’ exercise alone
 Nursing diagnosis for DM
o Fluid volume deficit r/t blood glucose exceeding renal threshold causing glucose to spill
into the urine creating an osmotic diuresis and electrolyte losses AEB thirst and
increased appetite
o Risk for injury r/t hypoglycemia
o Deficient Knowledge (Diabetes Management) r/t care of child with newly diagnosed
Diabetes Mellitus
 Encourage Patients to:
o Maintain regular clinical visits
o Self-management
 Check blood sugars as ordered by physician
o Take all prescribed medications
o Eat a healthy well balanced diet
o