retaking blood sugars

[2011_RN]

Pt is a diabetic and accu-cheks ac&hs.

At 5 pm bs is 76

At 9 pm bs is 78

So the night nurse wanted me to recheck the bs....

According to our hypoglycemia protocol give juice/d50/glucagon if below 70 then recheck in 15 min.

I did check the patients bs and it was 84. The patient was not symptomatic and had been running at that level all day. That's why I didn't recheck it earlier.

So when do you retake a patients blood sugar? At certain level?

[SubSippi]

I'd recheck it a few hours later if it was in the 80s, especially for a new patient. If I can look back on the labs and see that it's normal for that patient at that time of day I don't worry about it.

[sbostonRN]

I'd be checking it at least q4h overnight, more often if the pt received oral hypoglycemics or long acting insulin. Those numbers are great but have potential to drop quickly, especially since most people don't eat overnight.

[pRNss808]

I like to keep my patients' glucose levels above 100 over night. Anything lower can put them at risk of hypoglycemia by the time breakfast rolls along.

[nursejami]

I like to keep my patients' glucose levels above 100 over night. Anything lower can put them at risk of hypoglycemia by the time breakfast rolls along.

Yep. If they're lower, I'll give a bedtime snack. People often drop in the middle of the night...

[WillyNilly]

I would have rechecked it, given a snack and checked again. I wouldn't want it to dip while they sleep

[amoLucia]

I like to keep my patients' glucose levels above 100 over night. Anything lower can put them at risk of hypoglycemia by the time breakfast rolls along.

RIGHT!!! And if they're asleep when they bottom-out, how will you know it???

I seem to have a sixth sense about diabetic pts at nite. I've walked into rooms 'just to check' and the pt is cold, clammy, difficult to arouse and the FSBS/BGM registers "LOW". Saved another one!

If 3-11 tells me they had a problem, I recheck automatically. I would be more remiss if I DID NOT recheck than if I do. And no one has ever questioned my actions.

[doppelganger2]

It isn't going to hurt you or the patient to check a blood glucose level, it takes seconds. If they aren't on the hypoglycemic protocol it's left up to the discretion of the nurse when to check it,aka nursing intervention, don't need an order to do so. Better safe than sorry.

[havehope]

This is interesting because, my facility only takes bloodsugars at 7am, 11am, 4p, and 8p. They don't check any bloodsugars at night. However, during the day if it is below 70 we will give juice, and recheck. If it is not better we give the d50. Had a guy the other day that was in the 30s! He had to take multiple d50s and it would not come past the 40s, so nurses pushed the d50 through IV and it finally went to 91.