Avoiding Diabetes Complications: Three Things a CNA Can Do

Article Categories: Diseases & Basic Skills

Diabetes is a common disease that can develop serious complications. Constant attention is required to help patients stay as healthy as possible. Without treatment and regular testing, diabetic patients are at risk for:

• High and low blood sugar episodes
• Vision problems, including blindness
• Poor circulation, which can lead to amputation
• Nerve problems, causing pain and numbness

As the primary hands-on caregiver, a CNA has an important role in caring for diabetic patients. Elderly and chronically ill patients need special consideration. Here are three ways to support the treatment plan:

Using a glucometer/ glucose meter: Depending on your facility, you may be responsible for obtaining a blood sugar reading to report to the nurse. You’ll be trained on how to operate the glucose meter, which gives a quick snapshot of the patient’s blood sugar level. A few tips:

1. Always wash the patient’s hands with soap and water, to remove anything that might alter the result, says Marlene Bedrich, RN, MS, CDE, program coordinator for the University of California Diabetes Teaching Center. Alcohol is the second choice. With either method, make sure the skin is dry before using the lancet.

2. Don’t squeeze the blood out. If you do, extra fluid can be taken by mistake, giving a false reading. Use the second drop of blood for more accurate testing.

Learn about medications: You don’t need to become a pharmacist to care for your diabetic patients. But take time to ask your nurse about the medications your diabetic patients are on and when they start to work. Knowing more about these medications can help you:

1. Get meals to your diabetic patients on time. You will also want to make sure each patient eats at least a small amount of food, including some type of starch or carbohydrate, such as bread, potatoes, fruit, or milk.

2. Offer plenty of fluids. Good hydration is important for medications to work and for proper elimination of body wastes. Elderly or frail people may not feel thirsty, or they may be too weak to drink. Check the patient’s diet to make sure which fluids are allowed; patients generally cannot have sugary drinks or unlimited fruit juice.

Be aware of high- and low-blood sugar episodes: Even patients who are well-regulated with their treatments can occasionally experience reactions to medications, illness, infection, or stress. While a quick glucose check can give an accurate answer, knowing what to look for can prevent a crisis. Immediately tell the nurse if you suspect either of these:

1. High blood sugar (Hyperglycemia) happens when the blood glucose reading is over 200 mg/dl. Blood sugar always goes up after meals, but should come down within a few hours. Symptoms of a high blood sugar include, thirst, frequent urination, tiredness or fatigue, hunger and also irritability. It can be caused by eating too much sugar or carbohydrates, as well as not enough medication or illness. If untreated, it can cause a coma.

2. Low blood sugar (Hypoglycemia) occurs when the blood glucose reading is below 70 mg/dl. Watch for sweating, shakiness, nervous, and irritability in your diabetic patients. Elderly or sick people may not notice these symptoms, which can lead to complete confusion or unresponsiveness. The nurse will give a glucose gel or tablets, or a ½ cup of orange juice to quickly elevate the blood sugar.
Because you spend the most time with your patients, you may notice small changes before anyone else. By observing and reporting, you can keep a diabetic patient healthy and free from complications.

Because you spend the most time with your patients, you may notice small changes before anyone else. By observing and reporting, you can keep a diabetic patient healthy and free from complications.


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