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Chronic Patient Care
Hyperglycemia
The team at Nurseco aim to identify and care for the patient with acute hyperglycemia in the home setting and to promote self-care in the home.
Hyperglycemia arises when not enough insulin is available to metabolize blood glucose. Infection, noncompliance with medication, failure to follow prescribed diet, or emotional stress may precipitate hyperglycemia.
Signs and symptoms of hyperglycemia include increased thirst, increased urination, fruity or almond smelling breath, abdominal pains, weakness, deep breathing, loss of appetite, nausea, and vomiting.
Severe hyperglycemia is a true emergency and the patient requires immediate medical attention. Profound dehydration, rapid and weak pulse, seizures, and coma may occur. The blood glucose level may range between 300 and 3000 mg/dl. If hyperglycemia is not treated, death may result. Hydration and insulin therapy in a monitored setting are key elements of treatment for severe hyperglycemia
Hypoglycemia
Hypoglycemia may be caused by an excessive rate of removal of glucose from the blood or from decreased secretion of glucose into the blood.
The most common cause of hypoglycemia is unintentional insulin reaction.
Hypoglycemia may also result from advertent overmedication with sulfonylureas, decreased or delayed food intake, exercise, alcohol intake, or variable absorption of insulin from the injection site.
The signs and symptoms of hypoglycemia may develop rapidly and include cool or moist skin, tremors or seizures, diaphoresis, bounding pulse, personality change, anxiety, hunger, confusion, nausea and vomiting, and stupor or coma. Be aware that the patient may not recognize signs and symptoms of impeding hypoglycemia because of the neuropathies associated with diabetes.
Mild hypoglycemia is defined as a blood glucose level ranging between 50 and 70 mg/dl.
Moderate to severe hypoglycemia is defined as a blood glucose level less than 50 mg/dl and is often associated with neurologic symptoms and changes in the level of consciousness.
Hypertension
The purpose of Nurseco’s team in the prevention and treatment of hypertension (HTN) is:
HTN is diagnosed when there is a sustained blood pressure of 140/90 mm Hg or greater.
Essential or primary HTN lacks an identifiable cause.
Secondary HTN is diagnosed when a cause can be identified.
Unrecognized, untreated, or uncontrolled HTN can lead to damage of target organs and possibly cause the following conditions:
Congestive heart failure
Cardiovascular disease
Renal disease
Cerebrovascular disease
Peripheral vascular disease
Retinal disease
The following are diet-related diseases associated with HTN:
Overweight/obesity
Diabetes
Dyslipidemia