Exemplar - Hyperglycemia

Basic Patho: blood glucose level of >140 mg/dL, severe- >180 mg/dL. Glucose is typically reabsorbed in the
renal tubules. Hyperglycemia results in glucose excretion in the urine, which creates an excretion in the urine,
which creates an osmotic effect that effectively reduces water absorption into the renal tubules, leading to an
excessive volume loss through the kidneys. Hyperglycemia also causes hyperosmolarity in the blood, which
causes a shift of fluid from the intracellular space to the vascular space.

Manifestations Labs/Diagnostics

 Polyuria  Blood glucose checks (finger stick)

 Polydipsia  HgbA1C test
 Dehydration  Serum BUN and Creatinine levels
 Fatigue (elevations in BUN and creatinine
 Fruity odor to breath levels are indicative of decreased
 Kussmaul breathing renal function associated w/
 Weight loss microvascular changes that develop
 Hunger in the kidneys secondary to sustained
 Poor wound healing hyperglycemia.

Treatments/Interventions
Teaching
 Admin insulin as ordered.
 Regular blood glucose checks via
 Vitals signs (decreased BP and
finger sticks.
increased HR are secondary to the
 Healthy lifestyle that includes diet
fluid volume deficit created by
and exercise.
osmotic diuresis to hyperglycemia.
 Teach about subcut injections, sites
 Intake and output (temp may be
are abdomen and deltoid. Rotate sites.
elevated, if infection is present,
 Know signs of hyperglycemia,
increase in urine output can be an
secondary to inadequate insulin
indicator).
administration.
 Wounds are slow to heal due to vessel
 Regular physician visits are essential
damage that occurs secondary to
hyperglycemia. to monitor for cardiac, renal, visual,
and skin complications r/t
 Finger stick AC and HS
hyperglycemia.
 Foot examinations.