The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply.
A. Thirst
B. Palpitations
C. Diaphoresis
D. Slurred speech
E. Hyperventilation
Correct Answers: B, C, & D.
Hypoglycemia is often defined by a plasma glucose concentration below 70 mg/dL; however, signs and symptoms may not occur until plasma glucose concentrations drop below 55 mg/dL. The clinical manifestations of hypoglycemia can be classified as either neuroglycopenic or neurogenic.
Option A: Excessive thirst may be a symptom of high blood sugar (hyperglycemia). It’s important to be able to recognize any imbalance in thirst or urine production. It’s the function of the kidneys and other organs to help filter out impurities.
Option B: Palpitations, an adrenergic symptom, occur as the glucose levels fall; the sympathetic nervous system is activated and epinephrine and norepinephrine are secreted causing this response.
Option C: Neurogenic signs and symptoms can either be adrenergic (tremor, palpitations, anxiety) or cholinergic (hunger, diaphoresis, paresthesias). Diaphoresis is a sympathetic nervous system response that occurs as epinephrine and norepinephrine are released.
Option D: Neuroglycopenic signs and symptoms are signs and symptoms that result from direct central nervous system (CNS) deprivation of glucose. Slurred speech is a neuroglycopenic symptom; as the brain receives insufficient glucose, the activity of the CNS becomes depressed.
Option E: Rapid or labored breathing, known as Kussmaul breathing, can be a symptom of diabetic ketoacidosis (DKA). Ketoacidosis is a short-term complication of diabetes caused by very high blood glucose levels accompanied by a high level of ketones in the blood.
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