At the very least, this facility should be teaching its CNAs the s/sx of hypo/hyperglycemia. Like the above poster mentioned, glucometers may not be quite accurate and any pt who is symptomatic needs to recieve prompt treatment, or further assessment.
Do NOT be too timid to interrupt report if you feel something is wrong with a pt. Having a co-worker be annoyed at you is a small price to pay for prevent serious complications for a patient.
Protocols are fantasic, however, they are no replacement for your eyes, common sense, and gut feeling. If this pt was symptomatic at 73 and confirmed that she felt like she had a low BG (long term diabetics usually know their body's well and can tell when there glucose levels are too low)...get some fast acting carbs and get the nurse! As long as she was not npo, you would do absolutely no harm. If the pt was npo, get the nurse...any nurse...asap and they can decide what to do from there.
See if your hospital Diabetes Educator can come speak with you and the other CNAs, or at the very least, give you some pt teaching materials that they give out to newly diagnosed diabetics...this is a great way to learn about pt care. Your facility will tell you which levels are considered normal vs. abnormal according to their policy, the protocol will determine how you treat/report, and the knowledge from the teaching materials will help you identify if the pt is symptomatic or not.
A symptomatic pt with a normal result needs treatment and I would have given the pt some juice as well...followed by some peanut butter and crackers.
We don't add sugar to OJ when giving for low BG.
Carbohydrates are quickly broken down into glucose, thus, raising the blood glucose levels. Simple carbohydrates are broken down more quickly than complex carbohydrates, therefore, are more effective in the immediate treatment of low BG levels. Since the body burns glucose so quickly, it is important to follow with a complex carbohydrate and protein to maintain a normal BG level and prevent another episode of hypoglycemia. Insulin is produced by the pancreas and stores excess glucose. Diabetics either (1) do not produce insulin, or (2) have insulin resistance and their need additional insulin to keep their BG levels in normal range. Insulin is given with meals in order to control BG levels as food is digested and broken down into glucose. Naturally, the more carbs a pt eats, the higher their BG will rise, and the more insulin coverage they will need. Many diabetics are advised to eat a certain amount of carb servings per day to prevent hyperglycemia. If the pt has insulin but does not cover with the appropriate amount of carbs, the insulin will cause an unsafe drop in BG levels causing hypoglycemia.