Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Mar 2013
ReviewManagement of hyperglycemia in the intensive care unit: when glucose reaches critical levels.
Hyperglycemia among hospitalized critically ill patients has been shown to be an independent predictor of poorer outcomes. Appropriate treatment of hyperglycemia among these patients has been associated with reduced mortality and morbidity. ⋯ The ultimate goal of treatment is to obtain glycemic control without causing undue hypoglycemia. This article discusses issues related to glycemic control among critically ill patients, glucose targets in this population, and best practices in the management of hyperglycemia in patients in the intensive care unit.
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Proper care of patients with diabetes during the perioperative period is crucial for preventing acute complications such as hyperglycemia, hypoglycemia, diabetic ketoacidosis, hyperosmolar hyperglycemic state, dehydration, and electrolyte imbalances. Many factors influence the optimal care plan, including the usual home diabetes regimen, the level of diabetes control before surgery, the surgery type, the duration of surgery, and the amount of time the patient will be fasting. An optimal plan of care is based on a thorough presurgical assessment and prescribing a regimen that will minimize acute complications. This article discusses recommendations for target blood glucose and diabetes medication adjustment during the perioperative period.