Unstable blood glucose levels in patients undergoing hemodialysis: concept análisis
Glicemia instável no paciente submetido à hemodiálise: análise de conceito
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Objective: to analyze the concept “Unstable Blood Glucose” in the context of patients undergoing hemodialysis. Methods: conceptual analysis, carried out using the method proposed by Walker and Avant and operationalized through a Scoping Review. Data were collected in January 2023, by searching for eligible publications in national and international databases and catalogs of theses and dissertations. Results: the critical attributes identified were: glycemic variation outside the normal range and hemodialysis. The antecedents identified were: Insufficient food intake/Fasting; Inappropriate use of insulin or hypoglycemic agents; Dialysate without glucose replacement; Diabetes Mellitus; and, Advanced age. The consequences were: Hyperglycemia; Hypoglycemia; Increased morbidity; Increase in mortality; Cerebrovascular events; and, Cardiovascular events. A model case and otherwise and empirical references were also constructed. Conclusions and implications for practice: the analysis of the concept “Unstable Glycemia” generated the definition of susceptibility to glycemic variation outside the normal range during and/or after hemodialysis. This knowledge contributes to a broader understanding of the phenomenon and can support the development of interventions that strengthen the prevention of the effects of glycemic variation in this clientele.
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