Protocol for diabetic Stomach ache.

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Specializes in Cardiology, School Nursing, General.

My student came in with a Stomach ache, we checked him and his machine was acting up, giving me a 31. Which is not possible, so we checked him again and he was 286. We checked his Ketones, it was moderate and I was doing his protocol of drinking water and resting. He stated that he ate dinner last night, but he couldn't find his machine, so he didn't do the carbs for it. He has been having this stomach ache all night and today, and didn't eat any breakfast.

I am trying to make him drink water, but he's refusing. I already called his mother to come pick him up because of his stomach ache.

What do you guys do in this situation? I'm thinking of maybe changing the pod, because it's on his thigh and last time it was there, it wasn't giving him his insulin properly.

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Specializes in School health, pediatrics.

Most of the schools in my area the staff do not change sites, parents have to come in to do that. If a pump is malfunctioning I can disconnect it , though. Otherwise I just follow the order. Usually water , take a walk, the orders we use have an area for a doctor to allow insulin if it has been x amount of time since last bolus.

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Specializes in Cardiology, School Nursing, General.
Most of the schools in my area the staff do not change sites, parents have to come in to do that. If a pump is malfunctioning I can disconnect it , though. Otherwise I just follow the order. Usually water , take a walk, the orders we use have an area for a doctor to allow insulin if it has been x amount of time since last bolus.

Yes, I'm making him walk around too. He's 293 now.

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Specializes in School Nursing.

Be careful of your scope of practice. Changing a site is an invasive procedure. I'd have a parent do it without a doctor order.

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Specializes in kids.
Be careful of your scope of practice. Changing a site is an invasive procedure. I'd have a parent do it without a doctor order.

His diabetic care plan could cover that. How old? Can he do the site change?

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Specializes in Cardiology, School Nursing, General.
His diabetic care plan could cover that. How old? Can he do the site change?

It does. I was given permission by the doctor, as well doctor's order to do it.

His father is here, so he's going home.

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Specializes in Cardiology, School Nursing, General.

I'm very worried though because on how this is being cared for at the doctor's office and at home. He's not following a diet because his doctor said he can eat anything as long as he has the carbs for it and puts insulin. And this causes him to have extremely high glucose, like today. Not only this his mother is in the hospital for kidney issues because she herself has TD1 and is getting worse.

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Specializes in ICU/community health/school nursing.

If you're really worried, file a report with CPS for neglect. You don't have to prove neglect, just suspect it. You can't "make" anyone do anything, especially make a pre-teen drink water.

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Specializes in Med-surg, school nursing..

I will add that a glucose of 31 is entirely possible. (No stark intended)

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Specializes in kids.
I'm very worried though because on how this is being cared for at the doctor's office and at home. He's not following a diet because his doctor said he can eat anything as long as he has the carbs for it and puts insulin. And this causes him to have extremely high glucose, like today. Not only this his mother is in the hospital for kidney issues because she herself has TD1 and is getting worse.

Because that is what the docs are doing now. All my kids pretty much eat what they want as long as they cover it. I'm sure they are taught carb counting, ratios etc. But the idea is to let them live as normal a life a possible (eating what their friends do) AS LONG as they cover the intake!!! (And the spike as needed). So I would be careful about querstioning the quality of care. It may be very good, but the doc is not sitting in class with the child. Is all of that info spelled out in the DCP? Are they testing as ordered?

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Specializes in school nursing, ortho, trauma.

glucose that low is indeed possible. What's more is that it's possible for them to be strolling into my office like it's nothing and "feeling fine" with it. I've seen it and am equally shocked every time when they "feel fine".

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Specializes in Cardiology, School Nursing, General.
Because that is what the docs are doing now. All my kids pretty much eat what they want as long as they cover it. I'm sure they are taught carb counting, ratios etc. But the idea is to let them live as normal a life a possible (eating what their friends do) AS LONG as they cover the intake!!! (And the spike as needed). So I would be careful about questioning the quality of care. It may be very good, but the doc is not sitting in class with the child. Is all of that info spelled out in the DCP? Are they testing as ordered?

All the info is in there, but is it normal for a 9 year old to be always in the 200s? Because it's very high, higher than his target range is and we are always checking him. I know that he may be cared for really well at home, but I'm just worried that his glu are high at times, and it fluctuates a lot.

As what the first reading was, I know it is possible, but I wanted to make sure and it was higher than it was when I checked him again.

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