How should hypoglycemia be addressed in acute stroke management?

How should hypoglycemia be addressed in acute stroke management?

• A. Treat promptly with glucose; adjust therapy to maintain euglycemia
• B. Delay glucose until after MRI
• C. Ignore glucose levels
• D. Over-correct to hyperglycemia

Answer: (A)

Prompt correction of low blood glucose is essential in acute stroke care. Hypoglycemia can mimic stroke symptoms and worsen neurological injury, so you should treat promptly with glucose to restore normal brain energy and then adjust the plan to keep glucose in the normal range. For a patient with hypoglycemia, administer rapid-acting glucose (such as IV dextrose if the patient cannot swallow or is not alert) and then monitor and adjust insulin or dextrose to maintain euglycemia as part of ongoing stroke management. Do not delay glucose in hopes of imaging or other tests, do not ignore glucose levels, and do not overshoot toward hyperglycemia, since both extremes can worsen outcomes. After stabilization, maintain glucose in the normal range to reduce additional brain injury.

Prompt correction of low blood glucose is essential in acute stroke care. Hypoglycemia can mimic stroke symptoms and worsen neurological injury, so you should treat promptly with glucose to restore normal brain energy and then adjust the plan to keep glucose in the normal range. For a patient with hypoglycemia, administer rapid-acting glucose (such as IV dextrose if the patient cannot swallow or is not alert) and then monitor and adjust insulin or dextrose to maintain euglycemia as part of ongoing stroke management. Do not delay glucose in hopes of imaging or other tests, do not ignore glucose levels, and do not overshoot toward hyperglycemia, since both extremes can worsen outcomes. After stabilization, maintain glucose in the normal range to reduce additional brain injury.