diabetic patient

[Mavy]

im really confused about this D5W given with a patient with high glucose in blood. Is it really ok to give it to that patient? the doctor give D5W with a patient that has 229 mg/dl rbs the patient has tremor and has sweating all over. so he order this D5W. but after giving it the patient stop the tremors and was ok but the glucose increases it became 389 mg/dl, she is also taking high dosage of insulin. pls help me out. so confused

[SoldierNurse22, BSN, RN]

D5W is contraindicated in hyperglycemia. I'm not sure why the doc would order D5W. The tremor and sweating may have been a direct result of the hyperglycemia.

Anyone else?

[CDEWannaBe]

Not sure the doctor's reasoning for D5W.

The patient likely has sky high glucose normally. Our bodies are very adaptable and if patient is consistently hyperglycemic it becomes his or her new "normal" and patient will have low blood sugar symptoms if levels fall below that. My husband once helped a man with all the classic hypo symptoms and when the man was tested his blood sugar was 500! But he'd just been released from the hospital after being treated for a blood sugar of 1,200. Since his blood sugar was so elevated the 500 felt like hypoglycemia and his body had a hypo response.

Even though hyperglycemia feels normal to a patient is consistently high levels, it's not benign. Hyperglycemis still damages the patients small blood vessels in eyes and feet and overtaxes the kidneys.

The body can adapt back down to lower blood sugars. It usually takes a couple days or weeks of suffereing through the low blood sugar feeling and trusting the meter is correct, even though patient feels hypoglycemic.