Medical-Surgical Nursing II · Chapter 1

The A1C, the 3 a.m. Check and the Surveillance Calendar

Assessment in diabetes is two jobs at once: find today’s glucose problem, and audit the schedule that prevents the complication you will otherwise meet in five years. Set a target for a real patient rather than reciting “below 7”, solve a morning high with a single 3 a.m. glucose, then run the surveillance audit and see what is overdue.

Work the patient up

Current A1C (%) Who is this patient? Has had one or more episodes of hypoglycaemia below 54 mg/dL in the last three months Regimen unchanged and the patient has been stable at goal

A target is a clinical judgement, not a reflex. The harm of a low sugar in a frail elder plainly outweighs the benefit of a tight one.

Set a targetEnter an A1C and tell me who the patient is

Waiting

Choose a mode on the left.