Just want to throw a question out and see if I can get an answer before I leave for work tomorrow morning. I do hospice nursing, and I have a pt who just recently had a stroke about 10 days ago. This is not the reason he's on hospice, though. He was on our service prior to this due to CAD. But anyway, he had a stroke about 10 days ago. So, where he used to eat plenty, he now barely consumes a jar of baby food and a half a can of glucerna per day. And his blood sugar has been steadily climbing ever since. He had diabetes prior to this event also, but his BG usually ran between 100-200. Never as high as it currently runs. It's been creeping into the 300-400 range for the last 4-5 days. My interdisciplinary team meeting is tomorrow morning, so I'm going to tell our dr about this and see if he'll give a sliding scale or something. Normally, the pt gets Humulin-N 25units every day, unless his BG is below 70. He has no other insulin or oral anti-diabetic agents.
What I want to know is why this BG is going so high. I've got so much other stuff going on in my head that I just can't focus in on what's causing it to skyrocket like this. I know that BG can become elevated when the body is under stress, and I suppose a stroke does qualify as stress, but should it still qualify as stress since it's been almost 2 weeks since the stroke? I just don't want to look like a complete moron when I tell the dr about this tomorrow and have not even the slightest hint of what might be causing it. He's a nice dr actually, and I know he wouldn't begrudge me a little knowledge, but I'm vain I guess. So, all you A&P gurus out there, please throw me a hint if you can about what's up with my poor pt. All I can guess at is it's either stress from the stroke, or maybe he's developed an infection while he was in the hospital? Thanks so much to anyone who takes a shot!
Oh, and I guess I'll throw in that the other meds he takes aren't the kind that normally interfere with BG. No steroids or anything. Nothing new...
