HYPOGLYCEMIA

NCMB 316 CASE PRESENTATION:
HYPOGLYCEMIA
BSN 3-B-7
Group 673
CASE STUDY: Hypoglycemia
Patient Profile
After running in a half marathon, F.W., a 24-year-old
woman 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 that 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
• Completed the half marathon in a personal-best time
Obiective Data
• Has slurred speech and unsteady gait
• HR: 120 bpm
• Appears confused
• Capillary blood glucose level: 48 mg/dL (2.7 mmol/L)
Describe what F.W.
could have done to
prevent this
hypoglycemic event.
Describe what F.W. could have done to prevent this hypoglycemic event.
In this case scenario, F.W. experienced a hypoglycemic event after completing a half marathon, which
is considered a strenuous activity, and this induced physical stress on the patient, especially that the
patient committed this physical activity without having enough meal to compensate for the body's
needs. To prevent such an event, F.W. could have taken the following measures:
Adjusting insulin dosage: F.W. may have modified her insulin

dosage in accordance with her healthcare professional prior to
engaging in a physically demanding activity like a half marathon. If
she consumes a proper amount of meal prior to engagement, a
significantly lowered dose of short acting insulin is usually advised.
This would guarantee that she would have a proper and sufficient
amount of blood glucose for the activity.
Eating a proper meal: It is necessary to have a meal high in

carbohydrates two to three hours before engaging in strenuous
activity. F.W. may have made sure she consumed a healthy and
sufficient meal before running the half marathon. She may have
packed a quick snack to help keep her blood sugar levels stable if she
had less time.
Describe what F.W. could have done to prevent this hypoglycemic event.
In this case scenario, F.W. experienced a hypoglycemic event after completing a half marathon, which
is considered a strenuous activity, and this induced physical stress on the patient, especially that the
patient committed this physical activity without having enough meal to compensate for the body's
needs. To prevent such an event, F.W. could have taken the following measures:
Monitoring blood glucose levels: F.W. may have frequently checked

her blood sugar levels throughout the half marathon, especially if she
experienced any hypoglycemic symptoms. She could then take
appropriate action, like having a snack or lowering her insulin dosage.
Carrying snacks: In case F.W.'s blood sugar levels drop while she is
engaging in a physical activity, she should have made sure to keep a fast-
acting sugar source close by. A spoonful of sugar, energy bars, juice, or
ordinary soda are among the alternatives that would help keep her blood
glucose levels stable.
Informing others: She could have communicated to others that she

has diabetes and is susceptible to hypoglycemia, such as the first aid
tent workers or other runners. This would enable them to respond
appropriately in an emergency.
What is the etiology
of the manifestations
that the patient
displays?
When blood glucose levels fall below 48 mg/dL (2.7 mmol/L), the
sympathetic nervous system reacts by releasing adrenaline, which
causes symptoms like cold sweats, weakness, trembling, agitation,
irritability, pallor, and an accelerated heart rate. Because it cannot
store glucose or glycogen, the brain is dependent on a steady flow of
glucose. If the supply is inadequate, the client will experience
disorientation, weariness, and strange behavior.
It is crucial for individuals taking insulin to never skip meals and

engage in any vigorous activity, especially during the peak impact.
Nevertheless, in our patient's situation, she ignored her morning
breakfast then entered a marathon which resulted in her being
hypoglycemic or having a low blood sugar. Hereunder are the signs of
hypoglycemia that the patient shows:
She feels cold and has a headache; her fingers feel numb
Has slurred speech and unsteady gait
HR: 120 bpm
Appears confused
How would you
expect to treat F.W.'s
hypoglycemia?
Treatment for F.W’s Hypoglycemia:
Raise Glucose Level - one approach would
be to provide her glucose tablets or gel,
candy, juice, or regular soda. The treatment
should be repeated until her blood glucose
level returns to normal.
Monitor blood glucose level - continue to

treat the hypoglycemia until it is resolved.
The patient should also be monitored for any
signs of complications of hypoglycemia, such
as seizures or loss of consciousness.
Provide Health Teachings to the patient - it

is important to educate her on the
importance of adjusting her insulin dosing
and meal timing to accommodate her
physical activity and to prevent future
episodes of hypoglycemia.
Note:
F.W.'s hypoglycemia should be
treated immediately, as it can cause
significant harm if left untreated.
Hypoglycemia is a condition in which
the blood glucose level is lower than
normal, and in F.W.'s case, it is
significantly lower than normal.
Priority Decision:
What are the priority
teaching needs for
this patient once her
condition has
stabilized?
Once the condition of the patient has
stabilized, the priority teachings the
patient needs are the follow:
Stress the advantages of eating
healthfully and on schedule. Describe
why you should consume foods high in
carbohydrates before working out.
The best method to prevent low blood
sugar is to monitor your blood sugar
levels frequently and be prepared to
address it swiftly at all times.
While glucose tablets are advised
because they taste good, people are
unlikely to consume them unless their
blood sugar is critically low.
Inform F.W that carrying glucose tablets
or gel to treat low blood sugar is a smart
practice. If these trustworthy sources of
glucose are not accessible, you should
quickly consume a quick supply of sugar
such table sugar, honey, or candies. You
can also quickly raise your blood sugar
levels by drinking fruit juice or regular
soda. Inform the doctor of the reaction
right away. Low blood sugar is more
likely if significant amounts of alcohol
ingested, conduct exceptionally
strenuous exercise or do not get enough
calories from diet. Eat regularly and
don't miss meals to help prevent low
blood sugar.
Low blood sugar can be frightening and
uncomfortable, and it is typical to be
scared of future occurrences. Long-term
consequences may result if blood sugar
levels are kept high as a result of this. At
first, stay away from foods that are high
in fat (like candy bars) or protein (like
cheese), as these foods cause the body
to absorb glucose more slowly.
Suggest to the patient not to consume
alcohol
Educate patients and their loved ones on
the typical symptoms and indicators of
hypoglycemia.
What adjustments in
her diabetic regimen
could F.W. make to
allow her to continue
with her exercise
habits?
Patient F.W. has a well-maintained regimen for her type 1 diabetes which includes
self-monitoring of blood glucose, taking insulin, and diet. But she was brought to a first
aid tent because she felt uneasy, this may be due to the fact that patient F.W. not being
able to finish her meal after taking insulin. As a nurse, we can suggest the following
adjustments to F.W. to allow her to continue with her exercise habits (keeping in mind
that it is also ordered by the physician);
Take the regular insulin earlier, allowing at least 15-minute

intervals before taking her breakfast/meal, to avoid taking too
much of her time.
Take insulin at night or before bedtime because glucose

production is reduced, resulting in a better / improved blood
glucose level the following day.
According to the American Diabetes Association (n.d), if the blood
sugar level is less than 100 mg/dL before the start of the exercise, try
having a small carbohydrate snack (about 15g) to increase the blood
sugar and to reduce the risk for hypoglycemia.
Also, routine blood glucose tests are performed so that changing

insulin requirements can be anticipated and the dosage adjusted
if hypoglycemia occurs unexpectedly.
Hypoglycemia is prevented by a consistent pattern of eating,

administering insulin, and exercising. The between-meal and
bedtime snacks may be needed to counteract the maximum
insulin effect.
Priority Decision:
Based on the
assessment data
presented, what are
the priority nursing
diagnoses? Are there
any collaborative
problems?
The priority nursing diagnosis for F.W. based
on the assessment data presented are:
Risk for injury related to alteration in cognitive The second diagnosis that needs to be addressed
and motor functioning is imbalanced nutrition, which can be managed
Imbalanced nutrition: less than body by encouraging F.W. to consume quick-acting
requirements related to inadequate food carbohydrates to quickly raise her blood sugar
intake AEB patient is unable to eat her entire levels and prevent further hypoglycemia. Finally,
breakfast because of a lack of time. the patient's lack of knowledge about the
Deficient knowledge related to the lack of prevention and management of hypoglycemia
prevention and management of hypoglycemia should be highlighted as another diagnosis, and
AEB patient completing half of the marathon appropriate nursing education should be provided
without eating the entire breakfast and to reduce the risk of future episodes
developing symptoms of hypoglycemia
Collaborative problem:
Rationale: Seizures or loss of consciousness are potential
The highest priority diagnosis that must be collaborative problems that a patient may
considered is the risk of injury to the patient, experience as complications of hypoglycemia,
which requires immediate intervention to prevent which require immediate medical attention.
any possible harm to F.W. This will be achieved by
ensuring that she is in a secure setting and is
closely monitored to prevent falls or other
accidents.
MEMBERS:
BSN 3-B-7
Group 673
LOPEZ, BABY ELIZABETH L.

MACASASA, JOHN PATRICK
MANALO, YOHJ GODFFREY
MANLAPAS, RAINIER
MARCOS, JESSA MAE
MARTINEZ, KYLE ANDREI
MENDOZA, JC ANNE
OBLIPIAS, JANZEN
PICAZO, DROL SUSEJ
RAMOS, LEEANNE CYRILLE

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NCMB 316 CASE PRESENTATION:

Adjusting insulin dosage: F.W. may have modified her insulin

Eating a proper meal: It is necessary to have a meal high in

Monitoring blood glucose levels: F.W. may have frequently checked

Informing others: She could have communicated to others that she

It is crucial for individuals taking insulin to never skip meals and

Monitor blood glucose level - continue to

Provide Health Teachings to the patient - it

Take the regular insulin earlier, allowing at least 15-minute

Take insulin at night or before bedtime because glucose

Also, routine blood glucose tests are performed so that changing

Hypoglycemia is prevented by a consistent pattern of eating,

LOPEZ, BABY ELIZABETH L.

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