When teaching a client with diabetes about monitoring for episodes of hypoglycemia which symptoms would the nurse include in the teaching plan?

4. Sweating
When serum glucose decreases, the sympathetic nervous system is stimulated, resulting in a surge of epinephrine and norepinephrine; this response causes sweating, tremors, tachycardia, palpitations, nervousness, and hunger. Increased thirst (polydipsia) occurs in response to the osmotic diuresis associated with hyperglycemia. The ketosis and acidosis of diabetic ketoacidosis lead to gastrointestinal problems such as nausea, anorexia, vomiting, and abdominal cramping.

1. Leg ulcers
2. Loss of visual acuity
3. Thick, yellow toenails
5. Decreased sensation in the feet

Leg ulcers are a common response to the microvascular and macrovascular changes associated with diabetes. Retinopathy, damage to the microvascular system of the retina (e.g., edema, exudate, and local hemorrhage), occurs as a result of the occlusion of the small vessels in the eyes, causing microaneurysms in the capillary walls. Thick, yellow toenails result from prolonged inadequate arterial circulation to the feet. Pedal pulses diminish, which can result in gangrene, necessitating amputation. Diabetic neuropathies affect 60% to 70% of people with diabetes. It is theorized that consistent hyperglycemia causes a buildup of sorbitol and fructose in the nerves that results in impairment via an unknown process. Inadequate arterial circulation to hair follicles results in a lack of hair on the feet and ankles. The skin becomes dry and cracks, predisposing it to leg ulcers and infection.

3. Difficulty concentrating, hunger, and diaphoresis

Difficulty concentrating, hunger, and diaphoresis are the most common signs and symptoms of hypoglycemia. Increased adrenergic nervous system activity and increased catecholamine secretion produce hunger and diaphoresis. Difficulty concentrating reflects central nervous system glucose deprivation. Increased thirst, sleepiness, and nausea are signs and symptoms of hyperglycemia as ketoacidosis develops. Confusion, dry mouth, and diminished reflexes are signs and symptoms of hyperglycemia; they reflect ketoacidosis. Flushed face, deep breathing, and abdominal pain are signs and symptoms of ketoacidosis.

Which symptoms would the nurse include when teaching a client to recognize symptoms of hypoglycemia?

Which of the following signs and symptoms would be seen in a client experiencing hypoglycemia?

What are four signs that a patient is experiencing hypoglycemia?

What signs and symptoms may indicate an emergency situation relating to hypoglycemia?