HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 6-9
Endocrine: Hyperglycemia __RN
PURPOSE: 3. Obtain a blood glucose result using a meter for
To provide guidelines in the treatment of the
hyperglycemic patient in a home care situation.
CONSIDERATIONS:
1. Hyperglycemia can be defined as a greater than
normal amount of glucose in the blood, most
frequently associated with diabetes.
2. Hyperglycemia may be the result of a slow or
sudden rise in blood glucose.
3. Persistent hyperglycemia has been shown to be a
causative factor in such chronic complications as
diabetic nephropathy, diabetic retinopathy,
cardiovascular complications, and peripheral
vascular disease.
4. Causative factors for hyperglycemia include
inaccurate amounts of insulin and/or oral agents,
dietary non- adherence, infection, illness, stress,
MI/CVA, diuretic or steroid use, underlying
renal/cardiac disease, TPN and/or insulin
resistance.
5. Signs and symptoms of hyperglycemia include
polyuria, polyphagia, polydypsia, weakness, fatigue
and blurred vision. It is also possible for the person
with diabetes to be asymptomatic.
blood glucose monitoring - follow the manufacturer's
directions for use of meter. (See Blood Glucose
Monitoring with Blood Glucose Meter, No. 6.04.) If
the blood glucose is greater than 300 mg/dl, repeat
the test to assure accuracy.
Note: To assure that the meter is functioning properly,
all quality control tests should have been completed with
results from these checks falling within expected range.
If necessary, the machine should be cleaned and the
strips checked for any defaults.
4. If the repeat blood glucose test is still greater than
250 mg/dl determine possible causative factors. It
is recommended that the MD be notified for blood
glucose levels greater than 250 mg/dl unless the
MD has previously ordered parameters.
5. Perform other assessment/treatment protocols per
MD's orders.
6. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Signs or symptoms of hyperglycemia noted.
b. Results of blood glucose test.
EQUIPMENT: c. Treatment given, patient's response to
Blood glucose meter
Automatic lancing device
Gloves
2.
treatment.
d. Instructions given to patient/caregiver.
Notify physician, if indicated.
Alcohol wipe
Puncture-proof container
Impervious trash bag
PROCEDURE:
1. Adhere to Universal Precautions.
2. Review patient's blood glucose log book, if
available. Ask about their activity, medication, diet,
and glucose monitoring results since the last home
visit. Assess compliance with treatment plan.
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