Y r all post-op pt tested for blood sugar

[coltsgrl]

What is the rationale that all of the patients on the surgical post-op floor are tested for blood sugar and have a standing sliding scale with novolog to be administered?

I am just wondering b/c my pt has a BS of 120 but is not/never been diabetic, the nurse said "it's just protocol"....so what causes high BS after surgery?

[Music in My Heart]

.... Deleted snarky response to the use of texting abbreviations on website.

[coltsgrl]

well, thanks for that response, that should completely turn the thread into that direction...just an answer would have been appreciated

wondering why some people can't bear to keep completely unnecessary comments to themselves? hmmmm

[Music in My Heart]

I know... it was snarky. It was only posted for about 10 seconds before I said, "dude, you're being a jerk" and edited it. I guess you read it before I edited it. My apologies.

To the point of your post...

A few thoughts come to mind...

1) Certain drugs (notably the corticosteroids) can result in hyperglycemia so perhaps this patient received large doses and they want to monitor it.

2) Was there something about the surgery that might be expected to affect the body's glucose control mechanisms?

3) In "Clinical Anesthesia, 5th ed" by Baresh, Cullen, & Stoelting they mention the occurrence of moderate postoperative hyperglycemia ("Glucose infusions and stress responses commonly elevate serum glucose levels after surgery"), though they say that it typically responds spontaneously and has "little adverse effect." Perhaps they're screening for that.

For what it's worth, our hospital does not routinely check blood sugars of post-op patients, so I'd challenge the assertion in your heading and post.

Again, my apologies for the snarky reply... it is, however, considered poor form by many people to use texting abbreviations in discussion forums.

[Daytonite, BSN, RN]

so what causes high bs after surgery?

these patients are getting iv infusions of dextrose directly into their blood stream. just a guess, but in some cases there may be some undiagnosed insulin resistance going on and the testing is to pick up on that.

[coltsgrl]

duely noted...I won't use them anymore

thank you for the responses

[ghillbert, MSN, NP]

The body undergoes stress during surgery which activates the sympathetic nervous system, and leads to increased circulating catecholamines (epi, norepi). Cortisol is also released from adrenal cortex which elevates blood gluose.

Patients may or may not receive dextrose infusions, but the body can usually cope with them. With surgical related stress, not so much (potentially).

There are multiple papers (although some are in heated debate) about worse post-surgical outcomes with untreated hyperglycemia - regardless of whether patients are diabetic or not.