What medication can the nurse administer intravenously to control the clients blood glucose level?
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Managing Hypoglycemia Treating hypoglycemia in the admitted patient who is able to eat or take po fluids “Miss Low” is not feeling well.  She is having symptoms of hypoglycemia. When you suspect hypoglycemia the first action to take is to confirm by checking the blood glucose using a blood glucose meter. This is called point-of-care testing (POCT). A result of less than 4mmol/L is considered hypoglycemia or low blood sugar and should be treated right away. Giving the patient 15 g of quickly absorbed sugar is the recommended treatment. Sugar given by mouth must be digested and absorbed before it reaches the blood stream. Items easily available to nurses on the ward that are quickly absorbed include: 175ml of juice or 3 pks of sugar diluted in water or 175ml or a regular soft drink. Some patients carry glucose tablets or candy for this purpose and these items can also be used if available and preferred by the patient. It takes about 15 minutes for this quickly absorbed sugar to reach the blood stream. You should repeat the blood glucose using POCT 15 minutes after treating the patient to confirm that the blood glucose is rising. If the blood glucose is still less than 4 mmol/L at this time you can repeat the treatment every 15 minutes until the blood glucose is at 4 mmol/L or above. Note that giving the patient a snack or meal before ensuring the sugar is at least at 4.0mmol/L will delay digestion and result in slowing the recovery from hypoglycemia. Giving the quickly absorbed sugar alone is very important to ensure that the blood sugar comes up quickly. Once you have confirmed that the patient’s blood glucose is at 4 mmol/L or above, you should give the patient a snack containing carbohydrates and protein or give them their meal if it is available. This will help maintain the blood sugar and prevent recurrence of low blood sugar. Whatever drug or situation is contributing to the low
blood sugar may still be present and lead to a low blood sugar again. Examples of carbohydrate and protein snacks easily available to nurses on the ward:
Once the patient is feeling better it is a good opportunity to talk to her about the symptoms of hypoglycemia. Remind her to call for help if she experiences these symptoms while in hospital. It is also a good teaching moment. Review and provide teaching on the appropriate treatment for hypoglycemia. Treating hypoglycemia in the admitted patient who is NOT able to eat, take po fluids or NPO If the patient is NPO, unconscious or unable to take fluids, give the patient 50ml 50% dextrose solution IV push over 1-3minutes. It is part of the protocol for pre-printed insulin orders. If the patient does not have pre-printed orders, call a physician right away for an order. Although this glucose is injected directly in the blood stream it must circulate and make its way to the capillaries to for the result of POCT to reflect the impact of the treatment. You should repeat the blood glucose by POCT 15 minutes after treating the patient to confirm that the blood glucose is rising. If the blood glucose is still less than 4 mmol/L at this time, give 25ml of 50% dextrose solution IV push over 1-3 minutes and ask a someone to advise the physician for further treatment instructions. Once the blood glucose is 4mmol/L or more and patient is NPO, ask the physician to assess if the patient needs an IV dextrose infusion such as 10% dextrose in water to prevent further hypoglycemia. If the patient is able to eat and you have confirmed that the patient’s blood glucose is at 4 mmol/L or above, you should give the patient a snack containing carbohydrates and protein or give them their meal if it is available. This will help maintain the blood sugar and prevent recurrence of low blood sugar. Whatever drug or situation is contributing to the low blood sugar may still be present and lead to a low blood sugar again. See examples of snacks above. As you can see the steps for treating hypoglycemia are the same in all cases:
If the patient is admitted: At The Ottawa Hospital our pre-printed orders and MAR (medication administration record) indicate that you should repeat the blood glucose by POCT again 60 minutes after a hypoglycemia event. We have added this step to our protocol in the admitted patient because these patients are usually acutely ill and when people are unwell they may have difficulty expressing or recognizing the symptoms of hypoglycemia. If you are from another institution you should check what protocols and policies are in place where you work. If Miss Low has had hypoglycemia more than once in a 24-hour period or in the last 2 to 4 days, you should inform the medical team. Her diabetes treatment may need to be reassessed and adjusted. It is not always best to hold diabetes medication as this can result in hyperglycemia which is associated with poor outcomes. It is important to keep in mind the peak action of the medication / insulin as well as assessing any changes to po intake, feeds, stress level, other drugs and activity before deciding what adjustments need to be made to prevent hypoglycemia from reoccurring. If your institution or organization has a specialized diabetes team, they would be a good resource. At The Ottawa Hospital, nurses can consult the diabetes nurse specialist. For more information see Chapter 14 Click on slides or video or read the full text. It’s your choice. If you are in an outpatient area: Canadian guidelines for driving with diabetes recommend that patients should eat carbohydrates if the blood glucose is between 4.0 and 5.0mmol/L before driving and should not drive for at least 45 minutes after the effective treatment of hypoglycemia. Driving guidelines: see page 137 paragraph 5 to 8 Support patient care and research at You might also like…This website gives you common facts, advice and tips. Some of it may not apply to you. Please talk to your doctor, nurse or other health-care team member to see if this information will work for you. They can also answer your questions and concerns.What type of medications are used for controlling blood glucose levels?There are different types, or classes, of drugs that work in different ways to lower blood glucose (also known as blood sugar) levels:. Alpha-glucosidase inhibitors.. Biguanides.. Bile Acid Sequestrants.. Dopamine-2 Agonists.. DPP-4 inhibitors.. Meglitinides.. SGLT2 Inhibitors.. Sulfonylureas.. Which type of insulin can be administered intravenously?The only type of insulin that should be given intravenously is human regular insulin. There is no advantage to using rapid-acting analogs in preparing insulin infusions because the rate of absorption is no longer a factor when administering insulin intravenously and can only result in added costs to the institution.
Which medication will the nurse administer to treat hypoglycemia?Severe hypoglycemia can be treated with intravenous (IV) dextrose followed by infusion of glucose. For conscious patients able to take oral (PO) medications, readily absorbable carbohydrate sources (such as fruit juice) should be given.
What is used in IV fluid to correct hypoglycemia?IV dextrose is the best treatment for inpatients and for patients found by emergency medical services personnel. IV dextrose is available in different concentrations. Concentrated IV dextrose 50% (D50W) is most appropriate for severe hypoglycemia, providing 25 g of dextrose in a standard 50-mL bag.
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