Question

What is the diagnostic procedure for glucose tolerance?

ACTIVE LEARNING TEMPLATE:Diagnostic Procedure

STUDENT NAME _____________________________________

PROCEDURE NAME ____________________________________________________________________ REVIEW MODULE CHAPTER ___________

Description of Procedure

Indications

Interpretation of Findings.

CONSIDERATIONS

Nursing Interventions (pre, intra, post)

Potential Complications.

Client Education

Nursing Interventions.

ACTIVE LEARNING TEMPLATES                                                                                                                                                                 TherapeuTic procedure A3

Answer 1

The diagnostic procedure performed to assess glucose tolerence is known as glucose tolerence test(GTT).

Test description:

The test is usually performed to assess how effectvely the body is utilizing the glucose. For the test to carry out the individual need to remain in fasting for 10-12 hours, with a minimum of 10 hours. So usually the test is carried out in morning after the previous night fasting. At first a fasting blood sample is collected from the individual to identify the FBS value and a urine sample also collected to identify any protein loss or ketone bodies. Later the individual is given with 75 gram of glucose mixed in cold water to drink. Then the blood samples are collected after each one hour. A minimum of 3 blood samples are collected ( within 3 hours). During these hours the individual is not allowed to eat anything, in case needed they can drink only the plain water. After collecting 3 blood samples for 3 hours, the individual can have his diet.

Indications of GTT:

GTT is usually conducted to identify the bodys ability to metabolise sugar effectively.It can be used for the diagnosis of gestational diabetes mellitus, insulin resistance, diagnosis of hypoglycemia, diagnosis of any known damage to beta cells of pancreas, Diagnosis of Diabetes mellitus, any inherited disorders that affect glucose metabolisms etc.

Interpretation of findings:

Fasting blood sugar below 95mg/dl is considered as normal findings.PPBS value 1 hour after drinking glucose solution should be below 180 mg/dl, after 2 hours, it should be below 155 mg/,dl and after 3 hours it should be below 140 mg/dl.Then it is considered as normal.Generally, Any value between 140-200 is considered as impaired glucose tolerence and the value above 200 mg/ dl will confirm DM.

Nursing interventions pre:

Advise the patient to remain in fasting for a period of 10-12 hours.Minimum of 10 hours.Should not drink any carbonated beverages, if they feel extreme fatigue, shivering, sweating etc,inform them to report to the physician immediately.

Nursing interventions Intra:

Withdraw the fasting sample and first urine sample, correctly notify the time of sample collection, advice the patient to remain in fasting until the sample collection is over, advise him to report any nausea, vomiting etc, make sure that he have taken the correct amount of glucose solution, carefully prepare the glucose solution.

Nursing interventions post:

Monitor for any fatigue, nausea, vomiting etc.advise to resume fasting and to have food, interpret the test results and clarrify the doubts.

Potential complications:

Nausea, vomiting, hypoglycemia, fainting, headache, risk for bleeding from needle site, hypotension etc

Client education:

Advise to follow a 10-12 hours of fasting, during which patient should not eat or drink any alcohol, carbonated beverages etc.

Advise to drink only the plain water if needed.

Adviseto take the regular medications on the previous night as per prescription.

Advise the patient to collect the mid stream urine.

If they feel extreme fatigue, tiredness , weakness during fasting inform the physician immediately.