Would you take a patient's blood sugar without an "order"?

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Especially if the patient asked you to because they were on solu-medrol and a diabetic? I would.

I've found that a pt's request for a finger stick can be the most telling "sign" of hypoglycemia especially in pts who are already beta blocked.

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Specializes in Reproductive & Public Health.
I've found that a pt's request for a finger stick can be the most telling "sign" of hypoglycemia especially in pts who are already beta blocked.

There is truth to this, for sure!

I'm not talking about diabetic patients. I'm talking about kids who were temporarily on high dose methylprednisolone. They wouldn't be treating for a blood glucose of 150 mg/dL d/t steroids and we don't like to go around unnecessarily stabbing children with needles. Research doesn't show that it's necessary to regularly monitor blood glucose levels in patients receiving pulse methylprednisolone who are not diabetic anyway though. Monitoring their urine glucose is a less invasive way of checking for adverse reactions to the medication. Is it even necessary? Maybe not, but it was the protocol at this particular hospital along with hemoccult testing all stool. It's also done for babies with infantile spasms who are on corticotropin (ACTH) therapy. Their parents are instructed to check their urine for glucose daily at home during the 30 day course but no serum glucose monitoring is done unless the urine is positive.

Ah, thank you. That makes perfect sense.

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Well, I supposedly ticked off the doctorof this patient--- a diabetic on solu-medrol, normally controlled with oral meds. I work night shift, this was 0500 in the morning, I didn't notice that he probably should have been on a accucheck with sliding scale because it's day shift who gives this pt the januvia or whatever. I was just busy, busy, busy. Overloaded with extra patients because of the flu shot fiasco, but still trying to do my best by everyone. I don't know if I was "written up" for taking the blood sugar without an order yet, but already got a "heads up" that the attending wasn't pleased. What a joke.

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