Progressive Care Nursing Certification (PCCN) Practice Exam

Which method is recommended to achieve glycemic control in critically ill septic patients?

1. Maintaining blood glucose levels between 180 and 200

2. Avoiding all insulin administration

3. Strict control of blood glucose below 140

4. Maintaining a blood sugar level below 180 while avoiding hypoglycemia

The correct answer is: Maintaining a blood sugar level below 180 while avoiding hypoglycemia

Maintaining blood sugar levels below 180 while avoiding hypoglycemia is supported by current evidence-based guidelines for managing glycemic control in critically ill septic patients. This approach balances the benefits of controlling hyperglycemia—such as reducing the risk of infection and improving overall outcomes—while minimizing the potential dangers of hypoglycemia, which can lead to further complications in critically ill patients. In critically ill patients, particularly those with sepsis, premature strict control of blood glucose to levels below 140 can increase the risk of hypoglycemia, which is harmful and can exacerbate the patient's condition. The recommendation to maintain blood glucose levels below 180 allows for a safer window of control that helps reduce morbidity without subjecting patients to the potential risks associated with lower glucose levels. This method emphasizes the importance of a measured approach to glycemic control in the intensive care setting, aligning with research findings that suggest a less stringent target is optimal for reducing adverse effects and improving patient safety.