Key Concepts
Overview
Clinical relevance: Hyperglycemia (blood glucose >180 mg/dL in hospitalized patients per ADA guidelines) is present in >30% of all hospitalized patients โ not just those with known diabetes. It occurs in diabetics and non-diabetics alike during illness, surgery, steroid therapy, and critical illness. The PN monitors glucose, administers ordered insulin, and recognizes when hyperglycemia is escalating toward a crisis (DKA or HHS). Inpatient glucose targets (ADA): - Non-critical care: 140โ180 mg/dL (pre-meal goal) - Critical care (ICU): 140โ180 mg/dL (tighter control increases hypoglycemia risk) - Notify provider: typically glucose >250 mg/dL (facility-specific threshold); always notify when DKA/HHS signs are present regardless of specific number Key NCLEX distinction: Hyperglycemia is not a single disease โ it is a finding. The PN responds to the NUMBER and to the CLINICAL PICTURE. A glucose of 310 in a stable Type 2 diabetic on oral agents requires a different response than a glucose of 310 with vomiting, fruity breath, and Kussmaul respirations (DKA). On the exam, writers often pair stable-sounding options with unstable dataโnotice the mismatch before you commit. If the stem names a...