Hypoglycemia Case Study
After running a half marathon, FW, a 24 year old female with Type 1 diabetes was
brought to the first aid tent provided for participants in a charity run. She is well
maintained on a regimen of self -monitoring of blood glucose, insulin and diet.
Subjective data:
States she feels cold and has a headache; her fingers feel numb.
She took her usual insulin dose this morning, but was unable to eat her entire breakfast
because of a lack of time.
She completed the half marathon in a personal time best.
Social History
Denies tobacco use
+ ETOH use; 1-2 glasses of wine on the weekends
Medications:
Lantus 28 units SQ QHS
Humalog AC and HS
Objective data:
VS: BP: 90/70 HR: 120 bpm RR 22
Physical Exam:
General: thin Caucasian female, with unsteady gait, slurred speech; appears confused.
Neuro: confused. MAE, unsteady on her feet.
HEENT: conjunctive clear, EOMI, PERRLA, dry mucous membranes
Neck: - JVD, no carotid bruits, bilaterally
Lungs: clear bilaterally
Cardiac: Regular S1, S2; tachycardic
Abdomen: flat, + BS times 4 quadrants, - abdominal bruit, soft, NT, ND, - HSM
Extremities: - edema, bilaterally, feet warm, DP/PT 1+ bilaterally.
Skin: Warm, dry; poor skin turgor
Blood glucose level: 48mg/dl
MD Orders:
Admit to ED
Bedrest
120 ml Orange juice; repeat as necessary
Monitor Blood Glucose Q 15-45 minutes until stable > 70 mg/dl
IV med lock
Start meds:
Glucagon prn blood glucose< 60
D50 prn < 60
Lantus Insulin
Insulin Sliding Scale
Discussion Questions
1)
2)
3)
4)
Describe what FW could have done to prevent this hypoglycemic event.
What is the etiology of the manifestations that the patient displays?
How would you expect to treat FW’s hypoglycemia?
What are the priority teaching needs for this patient once her condition has
stabilized?
5) What adjustments in the diabetic regimen could FW make to allow her to
continue with her exercise habits?
6) Based on the assessment data presented, what are the priority nursing diagnoses?
Are there any collaborative problems?