Theses and Dissertations at Montana State University (MSU)
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Item The statistical variance of blood glucose levels of medicial intensive care unit patients while on an insulin infusion protocol(Montana State University - Bozeman, College of Nursing, 2006) Ackerman, Kimberly Lynn; Chairperson, Graduate Committee: Karen ZulkowskiHyperglycemia has been shown to have many negative consequences in the critically ill patient. Many physicians and nurses have been searching for ways to provide quality care for the critically ill and decrease the hyperglycemia found in the diabetic and nondiabetic Intensive Care Unit (ICU) patient. Many physicians and nurses around the world are studying the use of the insulin infusion protocol to combat the hyperglycemia and therefore decrease the negative consequences associated with hyperglycemia. This study was a retrospective chart review of medical ICU patients in three months in 2003 and the same three months in 2004 in order to determine the statistical variance of blood glucose readings while on an insulin infusion protocol (IIP). There is little literature about the nurses' experience with the IIP. The study used medical patients from the Billings Clinic ICU in Billings, Montana who met inclusion criteria. Patients from the 2003 population utilized an IIP from 2002 and patients in the 2004 population utilized an IIP from 2003. Blood glucose readings were recorded and analyzed using SPSS 14.0. The study found no statistical difference in blood glucose readings due to a small sample size. There were interesting trends in the blood glucose data from 2003 to 2004. The results of the trends could be related to a more proficient understanding of the protocol and the rationale behind the protocol from the bedside nurse, as they are the sole operator of the protocol. Imogene King's Theory of Goal Attainment is one to be utilized for nurses operating the IIP. The goal of the IIP is to decrease hyperglycemia, therefore increasing the health of a person. Imogene Kings' theory integrates a personal, interpersonal, and social systems level to attain the ultimate goal, health. Nurses operating the IIP can utilize Imogene King's theory to attain health for the patient.Item Psyllium lowers blood glucose and insulin concentrations in horses(Montana State University - Bozeman, College of Agriculture, 2010) Peterson, Jyme Lynn; Chairperson, Graduate Committee: Shannon Moreaux.The metabolic effect of feeding psyllium daily to horses is unknown. Eight 11- to 16-yr-old (Trial 1) and sixteen 7- to 16-yr-old (Trial 2; Trial 3) light breed stock horses were used in a completely randomized design to determine the effects of psyllium supplementation on BW, BCS, neck circumference, tailhead fat, plasma glucose, insulin, leptin, ghrelin, and adiponectin concentrations. An intravenous glucose challenge was also performed and the same variables were measured (Trial 3). Horses were stratified by sex and BW and put on trial for 42 d (Trial 1) and 60 d (Trial 2). Horses were individually fed a grain ration at 0.5% BW (Trial 1) and 0.25% BW (Trial 2), hay at 1.5% BW (Trial 1;Trial 2), and a psyllium treatment. Psyllium treatment levels for Trial 1 were: 1) 90 g/d psyllium or 2) an isocaloric control and 0 g/d psyllium. In Trial 2 levels of 180 and 270 g/d psyllium were added. Trial 3 took place the day after Trial 2 ended; horses were administered an intravenous dextrose solution at 0.5% BW after a 12 h fasting period. In Trial 1, horses fed psyllium had a greater (P = 0.01) increase in neck circumference than those not fed psyllium. Trial 2 revealed treatment by time interactions for glucose (P < 0.001) and insulin (P = 0.03). Glucose was lower 90 min (P = 0.05) and 120 min (P < 0.001) after a meal in horses fed psyllium compared to those not fed psyllium. Insulin concentrations were lower 90 min (P = 0.002) and 300 min (P < 0.001) in horses fed psyllium compared to those that were not. There was no difference in glucose (P = 0.48) or insulin (P = 0.15) concentrations between horses on 90, 180, or 270 g psyllium treatments. In Trial 3, horses fed psyllium had lower glucose (P = 0.03) and adiponectin (P = 0.02) concentrations than horses not fed psyllium. Supplementing horses with any level of psyllium appears to lower concentrations of plasma glucose and serum insulin after a meal.