1. Laboratory evaluation of glycosylated hemoglobin should be performed every 3 months.
2. Illness , infection, and stress increase the need for insulin and insulin shouldn’t be withheld during illness or stress or infection because hyperglycemia and ketoacidosis can result.
3. When the child is not receiving anything by mouth for a special procedure,verify with the physician the need to withhold the morning insulin and when food , fluids, and insulin are to be resumed.
4. Instruct the child and parents in the administration of insulin
5. Instruct the child and parents to recognize symptoms of hypoglycemia and hyperglycemia
6. Instruct the parents in the administration of glucagon intramuscularly or subcutaneously if the child has a hypoglycemic reaction and is unable to consume anything orally
7. Instruct the child and parents always to have a spare bottle of insulin available
8. Advise the parents to obtain a medic alert bracelet
1. Results provide information needed to maintain good glycemic control
2. Instruct the child and parents about the proper procedure for obtaining the blood glucose level
3. Stree the importance of handwashing before and after procedure.
4. Stress the importance of following the manufacture’s instruction for the blood glucose monitoring device.
5. Instruct the child and parents to caliberate the monitor.
6. Instruct the child and parents to to check the expiration date on the strips.
Sign and Symptoms of Hypoglycemia
1. Hypoglycemia is blood glucose level less than 70 mg/dl.
2. Hypoglycemia results from too much insulin ,not enough food, or excessive activity.
3. Signs include headache,nausea, sweating, tremors, lethargy, hunger, confusion, slurred speech, tingling around the mouth, and anxiety
1. Elevated blood glucose level more than 250 mg/dl
2. Signs include polydipsia, polyuria,polyphagia, blurred vision,weakness, weightloss,and syncope.
1. Check the blood glucose level
2. Give ½ cup of fruit juice or other acceptable item.
3. Take the child’s vital signs
4. Retest the blood glucose level
5. Give small snack of carbohydrate and protein
6. Document the complaints, actions taken and outcome.
1. ½ cup orange juice or sugar sweetened carbonated beverage
2. 8 oz of milk
3. 1 small box of raisins
4. 3 to 4 hard candies
5. 4 sugar cubes
6. 3 to 4 lifesavers candies
7. 1 candy bar
8. 1 tsp honey
9. 2 or 3 glucose tablets.
Dha exam syllabus for Nurse And Midwife
1) FUNDAMENTALS OF NURSING
- Basic physical care
- Basic psychosocial needs
- Medication and IV administration
- Basic physical assessment
- The nursing process