Davis's Lab & Diagnostic Tests
Glucose
To view the entire topic, please log in or purchase a subscription.
Nursing Central is an award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Explore these free sample topics:
-- The first section of this topic is shown below --
Synonym/Acronym:
Blood sugar, fasting blood sugar (FBS), postprandial glucose, 2-hr PC (post cibum).
Rationale
To assist in the diagnosis of diabetes and to evaluate disorders of carbohydrate metabolism such as malabsorption syndrome.
Patient Preparation
There are no activity or medication restrictions unless by medical direction. There are no restrictions for the random glucose test. Instruct the patient to fast for at least 8 hr before specimen collection for the fasting glucose test and not to consume any caffeinated products or chew any type of gum before specimen collection; these factors are known to elevate glucose levels. Instruct the patient to follow the instructions given for 2-hr postprandial glucose test. Some health-care providers (HCPs) may order administration of a standard glucose solution, whereas others may instruct the patient to eat a meal with a known carbohydrate composition.
Normal Findings
Method: Spectrophotometry.
| Age | Conventional Units | SI Units (Conventional Units × 0.0555) | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Nondiabetic, fasting | |||||||||||||||||||||||||||||||||||||||||
| Cord blood | 45–96 mg/dL | 2.5–5.3 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Premature infant | 20–80 mg/dL | 1.1–4.4 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Newborn 2 days–2 yr | 30–100 mg/dL | 1.7–5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Child | 60–100 mg/dL | 3.3–5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Adult–older adult | Less than 100 mg/dL | Less than 5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Nondiabetic, 2-hr postprandial | 65–139 mg/dL | 3.6–7.7 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Nondiabetic, random | Less than 200 mg/dL | Less than 11.1 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Prediabetic, fasting | 100–125 mg/dL | 5.6–6.9 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Prediabetic, 2-hr postprandial | 140–199 mg/dL | 7.8–11 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Fasting means no caloric intake for 8 hr or longer. Values tend to increase in older adults. | |||||||||||||||||||||||||||||||||||||||||
Critical Findings and Potential Interventions
Glucose
Adults & children
- Less than 40 mg/dL (SI: Less than 2.22 mmol/L)
- Greater than 400 mg/dL (SI: Greater than 22.2 mmol/L)
Newborns
- Less than 32 mg/dL (SI: Less than 1.8 mmol/L)
- Greater than 328 mg/dL (SI: Greater than 18.2 mmol/L)
Timely notification to the requesting HCP of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.
Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.
Glucose monitoring is an important measure in achieving tight glycemic management. The enzymatic GDH-PQQ test method may produce falsely elevated results in patients who are receiving products that contain other sugars (e.g., oral xylose, parenterals containing maltose or galactose, and peritoneal dialysis solutions that contain icodextrin). The GDH-NAD, glucose oxidase, and glucose hexokinase methods can distinguish between glucose and other sugars.
Symptoms of decreased glucose levels include headache, confusion, polyphagia, irritability, nervousness, restlessness, diaphoresis, and weakness. Possible interventions include oral or IV administration of glucose, IV or intramuscular injection of glucagon, and continuous glucose monitoring.
Symptoms of elevated glucose levels include abdominal pain, fatigue, muscle cramps, nausea, vomiting, polyuria, polyphagia, and polydipsia. Possible interventions include fluid replacement in addition to subcutaneous or IV injection of insulin with continuous glucose monitoring.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Synonym/Acronym:
Blood sugar, fasting blood sugar (FBS), postprandial glucose, 2-hr PC (post cibum).
Rationale
To assist in the diagnosis of diabetes and to evaluate disorders of carbohydrate metabolism such as malabsorption syndrome.
Patient Preparation
There are no activity or medication restrictions unless by medical direction. There are no restrictions for the random glucose test. Instruct the patient to fast for at least 8 hr before specimen collection for the fasting glucose test and not to consume any caffeinated products or chew any type of gum before specimen collection; these factors are known to elevate glucose levels. Instruct the patient to follow the instructions given for 2-hr postprandial glucose test. Some health-care providers (HCPs) may order administration of a standard glucose solution, whereas others may instruct the patient to eat a meal with a known carbohydrate composition.
Normal Findings
Method: Spectrophotometry.
| Age | Conventional Units | SI Units (Conventional Units × 0.0555) | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Nondiabetic, fasting | |||||||||||||||||||||||||||||||||||||||||
| Cord blood | 45–96 mg/dL | 2.5–5.3 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Premature infant | 20–80 mg/dL | 1.1–4.4 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Newborn 2 days–2 yr | 30–100 mg/dL | 1.7–5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Child | 60–100 mg/dL | 3.3–5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Adult–older adult | Less than 100 mg/dL | Less than 5.6 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Nondiabetic, 2-hr postprandial | 65–139 mg/dL | 3.6–7.7 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Nondiabetic, random | Less than 200 mg/dL | Less than 11.1 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Prediabetic, fasting | 100–125 mg/dL | 5.6–6.9 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Prediabetic, 2-hr postprandial | 140–199 mg/dL | 7.8–11 mmol/L | |||||||||||||||||||||||||||||||||||||||
| Fasting means no caloric intake for 8 hr or longer. Values tend to increase in older adults. | |||||||||||||||||||||||||||||||||||||||||
Critical Findings and Potential Interventions
Glucose
Adults & children
- Less than 40 mg/dL (SI: Less than 2.22 mmol/L)
- Greater than 400 mg/dL (SI: Greater than 22.2 mmol/L)
Newborns
- Less than 32 mg/dL (SI: Less than 1.8 mmol/L)
- Greater than 328 mg/dL (SI: Greater than 18.2 mmol/L)
Timely notification to the requesting HCP of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.
Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.
Glucose monitoring is an important measure in achieving tight glycemic management. The enzymatic GDH-PQQ test method may produce falsely elevated results in patients who are receiving products that contain other sugars (e.g., oral xylose, parenterals containing maltose or galactose, and peritoneal dialysis solutions that contain icodextrin). The GDH-NAD, glucose oxidase, and glucose hexokinase methods can distinguish between glucose and other sugars.
Symptoms of decreased glucose levels include headache, confusion, polyphagia, irritability, nervousness, restlessness, diaphoresis, and weakness. Possible interventions include oral or IV administration of glucose, IV or intramuscular injection of glucagon, and continuous glucose monitoring.
Symptoms of elevated glucose levels include abdominal pain, fatigue, muscle cramps, nausea, vomiting, polyuria, polyphagia, and polydipsia. Possible interventions include fluid replacement in addition to subcutaneous or IV injection of insulin with continuous glucose monitoring.
There's more to see -- the rest of this entry is available only to subscribers.
