Shaky Shawna — Hypoglycemia
Cold and clammy, need some candy — 15 and 15
Shawna takes her insulin, gets pulled into a long meeting and never eats lunch. By two o'clock she is drenched in sweat, snapping at her coworkers and cannot remember the password she types every day.
Shawna's glucose falls under 70. Shaky, sweaty, tachycardic and irritable, then confused. Conscious: 15 grams of fast carbohydrate, recheck in 15 minutes. Unconscious: IV D50 or IM glucagon. Always follow with protein and complex carbohydrate.
Read Shaky Shawna's full story →The story arc
The setup
Regular insulin at 11:30, a skipped lunch, and an unplanned walk across campus.
The turn
Sweating, trembling, heart pounding, sudden irritability — cold and clammy.
The crisis
Glucose is 38. She is confused, slurring and cannot safely swallow.
The save
IV D50 restores her in minutes; once awake she gets crackers with peanut butter and a review of her insulin peak times.
NCLEX study section — Hypoglycemia
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Pharmacology
Take this chapter into practice questions on the same topic.