The Role of Nurses in Caring for Adult and Elderly Critically Ill Patients with Dysglycemia

Abstract

Dysglycemia is a common condition among critically ill patients admitted to intensive care units. It may manifest as either hyperglycemia or hypoglycemia, both of which have significant impacts on patient prognosis and survival. Maintaining blood glucose levels within an appropriate range is therefore a key element of effective critical care. The recommended target blood glucose range is 140–180 mg/dL, and intravenous insulin therapy should be initiated when glucose levels exceed 180 mg/dL. Tight glycemic control, defined as maintaining levels less than or equal to 110 mg/dL, is not recommended. Blood glucose monitoring should be performed every hour during the first 6–8 hours, then every 2 hours when levels remain stable for at least three consecutive measurements, and subsequently every 4 hours. Critical care nurses play a vital role in managing dysglycemia through ongoing assessment, close monitoring, collaboration with the multidisciplinary team, and prevention of complications related to inappropriate glucose levels. Therefore, it is essential for nurses to possess accurate knowledge and understanding of dysglycemia, including the importance of glycemic control, mechanisms of glucose regulation, contributing factors in critically ill patients, target glucose ranges, and appropriate nursing management. This knowledge ensures timely, accurate, and professional patient care. The purpose of this article is to present comprehensive knowledge regarding dysglycemia in critically ill adult and older adult patients. It aims to enhance nurses’ understanding of the pathophysiological mechanisms, underlying causes, and evidence-based nursing approaches that can be applied in patient care to promote safety, minimize complications, and reduce mortality in this vulnerable population.