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I check BGL on my little babies on postpartum without an order if I feel they are showing signs of hypoglycemia. I also do the same for adults.
In the OP case I would get an order first because the patient is not symptomatic. Besides if the patient is a diabetic he may require some type of order for BGL.
The only reason I would take a patient's blood sugar without an order is if they were exhibiting signs of hypoglycemia acutely, and I have reason to suspect they might be- ie, not eating, on insulin, history of low blood sugars. High blood sugars due to solu-medrol are not an emergency, but something the physician should be aware of and address with a proper order in a timely fashion.
When I worked critical care, I had patients on solu-medrol and if there were no orders to check BS ac and hs, I would get orders. It's a steroid so it'll increase BS, so important to get orders to get it checked.
Other than that prn checks if objective assessments warrants one.
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Especially if the patient asked you to because they were on solu-medrol and a diabetic? I would.
In what setting? Acute or long term care. Just because the patient asked because they are on solu-medrol? Probably not.....that can wait for rounds and do a fasting the next day. I would explain to the patient that we would ask the MD when he came around that it would be OK until later.
Well, I work at a small hospital on a Med-Surg floor and our manager has been really wanting us to discuss the purpose and one side effect of one current medication with each patient q shift. Well, I just so happened to be doing that with an older patient who had a few questions/concerns early this morning when I was giving them this med. I was really busy at the 2100 med pass, and it didn't come up anyways. Since my shift was almost over at 0500, I passed the info along in report. I took the bs just because the patient had asked me to and I had time. Pt. was asymptomatic with a bs in the 200s. Since it wasn't critical, I didn't call the doctor about it. But, since it was well over 150, I thought I should pass this info along so that day shift might get a sliding scale order when this doctor made rounds in the am.
Nola009
940 Posts
Especially if the patient asked you to because they were on solu-medrol and a diabetic? I would.