Excalibur

Hypoglycemia/Hyperglycemia in the Critical Care Patient 

Instructor for this module is Daphney Jacques RN, BSN. Please email her with any questions or concerns on this topic at dwilson@twu.edu 

Required Readings:

Lough, M., Stacy, K., Urden, T. (2001). Thelan's Critical Care Nursing: Diagnosis and Management 4th ed. ISBN-13: 978-0323014618

For this Module please read chapter 36. In addition read the following articles:

Power Point Presentation for this module:  right click on the link and save to your computer, then open as a slideshow to view. There is a "quick view" here but you will not be able to hear the sound clips unless you save the file to your computer

Case Study for discussion: Please review the case study below.  Setup a time for your group to meet on Yahoo IM and discuss. You may start with a blog discussion but I recommend you all meet in "real time" to compose your findings. When you have finished your discussion, please submit a summary, in an essay format to me, your instructor -via email.

Case Study: 

Mr. Lee, a 56 year old male diagnosed with sepsis has a blood glucose of 364. He is intubated and mechanically ventilated in the ICU. He has a peripheral IV.

I. Based on your reading what is the best practice for managing this patients blood glucose?
Discuss tight glycemic control in patients with sepsis as well as in ICU.

II. What medication do you anitcipate to be ordered for the management of his hyperglycemia? What route and what interventions are required?
Discuss regular insulin IV and every hour blood glucose monitoring.

III. After 3 hours on the insulin drip you check his sugar and it's 51. What medication do you anticipate to administer?
Discuss dextrose 50%

IV. On assessment 6 hours later Mr. Lee whom was previously alert and oriented now is lethargic.
Discuss signs and symptoms of hypoglycemia.