HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 6-8
Endocrine: Hypoglycemia __RN
PURPOSE: PROCEDURE:
To provide guidelines in the treatment of the
hypoglycemic patient in a home care situation.
CONSIDERATIONS:
1. It is difficult to define hypoglycemia on the basis of a
specific blood glucose concentration especially in
people with diabetes. However, because lower
glucose levels impair defenses against subsequent
hypoglycemia, glucose levels lower then 72mg/dl
can be defined as hypoglycemia. Hypoglycemia
episodes vary greatly in severity. Due to individual
variation in severity, hypoglycemia is defined by
symptoms rather than specific blood glucose level.
Mild hypoglycemia symptoms may include:
sweating, trembling, tachycardia, dizziness, difficulty
concentrating, lightheadedness and poor
coordination. Severe hypoglycemia symptoms may
include: mental confusion, lethargy, inability to selftreat,
seizures and loss of consciousness. Be
aware that some patients may have asymptomatic
hypoglycemia.
2. In some patients signs and symptoms of
hypoglycemia may go undetected by the patient due
to normal aging process, autonomic neuropathy,
use of beta-blockers, and concurrent disease
processes.
3. Hypoglycemia is not a disease. It is a condition
caused by an underlying problem or disease that
prevents the body from maintaining normal levels of
1. Adhere to Universal Precautions.
2. Obtain blood glucose measurement. (See Blood
Glucose Monitoring with Blood Glucose Meter, No.
6.04.)
3. Treat if blood sugar is 72 mg/dl or less. Also treat if
the blood sugar is between 72-100 mg/dl and the
patient is experiencing symptoms of hypoglycemia,
e.g., tremors, diaphoresis, hunger, anxiety.
4. Give a rapidly absorbed carbohydrate such as one
of the following:
a. 4 ounces of unsweetened fruit juice (Apple juice
is recommended for patients with impaired renal
function.) Repeat after 15 minutes if symptoms
continue.
b. 6 ounces non-diet soda
c. 4 teaspoons of sugar in 4 ounces water
d. 3-4 glucose tablets
e. 8 ounce glass of milk (preferably no fat or low
fat)
5. Blood glucose should be retested in 15-30 minutes
to determine appropriate rise in blood glucose.
6. If the patient's next meal is more than one hour
away, an additional protein and carbohydrate snack,
e.g., sandwich, should be given.
7. Glucagon may be given in the event of loss of
consciousness if prescribed by the MD and if the
prescription is in the home. (See Glucagon
Administration No. 6.11.)
glucose in the bloodstream. 8. In the event of unconsciousness, seizure or coma,
4. Symptoms of hypoglycemia in insulin-treated
patients can occur with normoglycemic blood
glucose concentrations particularly if the blood
glucose concentrations are decreasing rapidly.
5. Patients taking insulin or oral agents to treat
diabetes should be instructed in the signs an
symptoms, treatment and prevention of
hypoglycemia.
EQUIPMENT:
Blood glucose meter
Automatic lancing device
Gloves
Alcohol wipe
Puncture-proof container
Impervious trash bag
emergency transport to the hospital (911) should be
arranged.
9. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Signs or symptoms of hypoglycemia noted.
b. Results of blood glucose test.
c. Treatment given, patient's response to
treatment.
d. Instructions given to patient/caregiver.
2. Notify physician of hypoglycemic incident.
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