Objectives Clinical Assessments and Interventions Referral for Medical Action 190 ● Previously unknown or recently determined hyperglycemia. ● Unconscious employee. Follow-up Actions ● Coordinate efforts with personal health care provider with em- ployee consent. ● Assess employee knowledge regarding illness, diet, oral med- ication, insulin administration, and foot care, and provide instruc- tion. ● Provide assistance and support with dietary instructions. ● Monitor blood glucose per stand- ing order. ● Discuss and monitor glycosylated (glycated) hemoglobin test or hemoglobin A-1-C test to measure blood glucose control for the pre- vious 2 to 3 months. This test should be performed at least an- nually as an indication of blood sugar control. Refer to classifica- tion chart on page 191. ● Counsel regarding exercise regi- men prescribed by personal health care provider. ● Consult with family members regarding treatment plan with employee permission. ● Observe insulin administration as appropriate. ● Assess cardiac risk factors. Determine degree of problem and stabi- lize employee. ● Assess employee status. ● If unable to differentiate symptoms from hypoglycemia, give employee sweetened beverage or any form of quickly absorbed glucose, such as sugar packets, commercial glucose products, or candy. ● Obtain accurate history if not already avail- able, including insulin usage. ● Follow protocol for measuring blood glu- cose if available. ● Monitor vital signs until stable. ● Refer to personal health care provider immediately for treatment and follow-up. Guideline continues on next page Objectives Clinical Assessments and Interventions Referral for Medical Action