A question please?..

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Okay i work in a small facility, we only have eight residents. I am the only cna and there is no other "medical staff", the other people that run it are the people that own it. Neither are nurses or anything like that. They do have a long history of running this place. But my question is. One resident today, he ate breakfast (cereal and a piece of toast, coffee and water to drink). Well my question is his sugar at lunch time (1:30) was 5 hundred and something. The woman that does the medicine didn't do anything but give his medicine and then send him in to eat lunch. Should she do something else. What could be driving his sugar so high. I can't say for sure if he ate anything else. He is not suppose to. They are not allowed to keep food in their room. Anyway i am just curious what do you think should be done. This is not the first time this has happened.

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Well, from my limited experiance (anyone else want to answer this one is welomed), I'd say that resident needs to get checked out, see if there have been medication doses missed, if illness or stress or something else is causing the spike in blood sugar. In the short term, I'd say insulin or oral meds should be given to bring that high of a BS down pronto. Unfortunatly, what seems to happen in cases like this is that this resident might run high BS for a few days until they are so acidic and full of ketones and dehydrated that they are totally visibly sick, then they get taken to the ED, but a lot of damage is already done and, and once the ED gets their BS back to normal, they are discharged without the underlying problem being addressed.

Now, this may or may not be applicable to your situation, but it is what came to mind when you told your story. Is there a consulting doc or nurse practicioner that can have a look at this patient before he needs to go to the ED? Or who can order insulin for when the BS spikes?

Anyone else with more experiance want to chime in?

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They give him insulin before meals. But it just seems scary to know this happns on more than one occasion. kwim. thanks

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Specializes in med/surg, telemetry, IV therapy, mgmt.

your concern is admirable, but i question that you have all the facts that are going on. it is inappropriate to make any judgments about what may or may not be being done for this patient without having all the facts and without knowing the credentials of the licensed people running and caring for these patients. you cannot state with certainty that the woman who does the medicine failed to do something about this patient's elevated blood sugar. you yourself stated that you were not sure if the patient had something else to eat that could have driven his blood sugar so high. problem-solving demands thorough assessment before decision making and then acting upon that decision. that does not sound like something that was done in coming to your decisions here.

you asked "well my question is his sugar at lunch time (1:30) was 5 hundred and something. the woman that does the medicine didn't do anything but give his medicine and then send him in to eat lunch. should she do something else."

  • you don't mention what medication she gave. for all we know, it could have been something to lower the blood sugar.
  • there is no reason behind anyone withholding a patient's food?
  • should she do something else? can't answer this because you just haven't given enough information. a prudent nurse would not make any assumptions based on inconclusive information.

i am just curious what do you think should be done.

  • nothing.
  • if i thought someone had done something wrong i would report them to their supervisor.

you can read about diabetes on many different websaites on the internet.

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