Purpose: The study was undertaken to evaluate the reliability and validity of hypoglycemia clinical judgment rubric which developed for investigation nursing student’s clinical judgement competency on hypoglycemia simulation practice. Methods: The study was a methodological study with 59 nursing students from Y University participating. Fifty video files were used to analyze nursing student’s clinical judgment competency. Rubric was consisted with 11 questions having 4 phases (beginning, developing, accomplished, and exemplary) and composed with 4 sub-categories (noticing, interpreting, responding and evaluation/reflecting). Results: The value of inter-rater reliability was r=.92 (p<.001) and Kendall tau b=.79 (p<.001). The value of intra-rater reliability was r=.92 (p<.001) and r=.99 (p<.001). Cronbach's α was .93 as internal consistency reliability. Construct validity by factor analysis, 3 factors were extracted and it explained 80.9% of the variance in clinical judgment competency. The value of competency of hypoglycemia clinical judgment was 2.47 (±.42). Conclusion: The hypoglycemia clinical judgment rubric can be used for assessing clinical judgment competency on simulation practice. Also, it can be applied for evaluation a clinical judgment as a nursing program outcome of nursing students.

This is the case report of a 58-year-old man who developed acute severe hypoglycemia after a spinal block. He had a history of injecting insulin combined with 50% dextrose for hyperkalemia control. After the spinal block, he presented with hypo-glycemic symptoms and went into convulsions. Following injection of midazolam and 10 ml of 50% dextrose, his mental state returned to alert. We recommend careful monitoring of blood sugar level of chronic kidney disease patients who under-go neuraxial block.

Stress induced cardiomyopathy is characterized by transient systolic dysfunction of the apical segment of the left ventricle, in the absence of obstructive coronary artery disease. The clinical presentation of stress induced cardiomyopathy is similar to that of an acute myocardial infarction. Onset of stress induced cardiomyopathy is frequently triggered by intense emotional or physical stress. Hypoglycemia is one type of physical stress that causes stress induced cardiomyopathy. We report on a case of this syndrome associated with hypoglycemia.