Blood sugars over 400

Specialties School

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Specializes in BNAT instructor, ICU, Hospice,triage.

The healthcare plan instructs to test the ketones and if negative then push non sugar fluids and water. Its a high school kid that is special needs.

So do you usually call the parents when it is this high, even if the healthcare plan says not to?

Just curious, his teacher wants me to call the doctor. I would rather call the mom.

Specializes in School Nursing, Public Health, Home Care.

I think the parent should be notified. Perhaps you can make arrangements with the parent to email or make a note in a daily journal if there is such a thing. You don't mention a correction dose, that might be explored also.

Specializes in Peds, Oncology.

We call parents for anything under 70 and anything over 300. Parents need to know if their kids are running high or low so they can communicate it to the MD in case the insulin needs adjusted.

I had a student with highs and lows all the time and her treatment plan read the same way. I always let mom know if she had a high over 250 or a low under 50. I usually just texted her this info and what we did. (for a low what carbs we gave, for a high whether there were ketones or not). Mom needs to know so she can communicate with the Dr. I did ask for permission and called the Dr once after they made an adjustment to her insulin and we were having some really big swings each and every day but I would have been calling her Dr. 3+ times a week if I called the Dr for every high. Good Luck.

Specializes in school nursing, ortho, trauma.

Over 400 hundred will definitely earn a call to the parents, pushed fluids and ketones if ordered. I'm always a bit surprised if when they aren't ordered. On the other end of the spectrum, i don't usually call unles the BS is under 50 unless they are really symptomatic.

What do you do with student who refuses to test for ketones with high blood sugars? Don't think it is ever done at home.

Specializes in kids.
The healthcare plan instructs to test the ketones and if negative then push non sugar fluids and water. Its a high school kid that is special needs.

So do you usually call the parents when it is this high, even if the healthcare plan says not to?

Just curious, his teacher wants me to call the doctor. I would rather call the mom.

I would call mom....and I would let the teacher know that I am doing what is needed/necessary and what the plan is, as signed off by the MD and the parent......;)

Specializes in School nursing.

I agree with what most everyone has said: I'd call mom. The BS levels I call home for are different for each one of the diabetics in my school, but if it is over 400 I'd be calling home for every one of those children.

Curious, how high does the BS need to be before your healthcare plan says to call home?

Specializes in BNAT instructor, ICU, Hospice,triage.
I agree with what most everyone has said: I'd call mom. The BS levels I call home for are different for each one of the diabetics in my school, but if it is over 400 I'd be calling home for every one of those children.

Curious, how high does the BS need to be before your healthcare plan says to call home?

It only says that there is no need to call parent for blood sugars over 250. That's all it says. I know the school has had problems with this mom. Or at least the case manager has got into it with her.

Last week, the student had an appointment. Came back and the only change in the health care plan was the breakfast insulin/carb ratio. It made no sense at all because sugars have been really high and now they changed breakfast dose from 20/1 to 25/1. So even though we don't have permission to call the doc, I did just to clarify that there was not some mistake on the doctor's office end and that the order was correct because we had been getting high blood sugars.

The nurse said that their office had been lowering the dose because of low blood sugars. Child is a poor historian so I didn't know any of this.

I have not heard anything so I wonder if the office called mom.

first of all..do NOT let the teacher dictate to you who you should call.... (im getting a little tired of teachers telling me what to do)..

if you have an order to test ketones: do it. if you have an order to call the doctor, do it (not one of my orders EVER said to call the doc). I would only call the parents if I was not sure what to do. If the numbers are random, it could be that they did not cover enough for what their intake was, HOWVER...if the numbers are running consistently high, I would then call the parents to inform....

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