Many times the patient will receive a long acting insulin once or twice daily

# Many times the patient will receive a long acting

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Many times the patient will receive a long-acting insulin once or twice daily, as well as a short acting insulin every 4 hours depending upon his blood sugar. To determine the amount of the short-acting insulin to administer, the nurse will have to refer to the physician’s sliding scale order. Example: Order: Regular insulin Sub-Q q 4 hr according to sliding scale below. The patient’s blood sugar was 235. How much insulin will the nurse administer? Based on the above sliding scale, you administer 4 units. Practice Problems # 18 Use the sliding scale above to determine how much Regular insulin should be administered based on the following blood sugar results. The answers are on pages 29-31 Rev 05/31/09 POINTS TO REMEMBER WHEN ADMINISTERING INSULIN 1. When mixing categories of insulin in the same syringe, always draw up the short-acting (unmodified) insulin first. 2. Gently roll the bottle of (modified) insulin to mix it before drawing up the dose. Do not shake the bottle vigorously. 3. Always have another nurse verify that you have drawn up the correct amount and type of insulin. 4. Only Regular (short acting) insulin can be given intravenously. 5. If not given correctly, insulin can be a lethal drug . Blood Sugar (mg/dL) Regular Insulin 0 – 150 No insulin 151 – 200 2 units 201 – 240 4 units 241- 280 6 units 281 – 330 8 units over 330 Call MD
19 of the dosage calculation packet. To obtain credit for dosage calculation questions, you must correctly label the answer. 1. 265 mg/dL = ___________________ 2. 75 mg/dL = ___________________ CALCULATING SAFE PEDIATRIC DOSAGES Infants and children require smaller quantities of drugs than adults. Their medications are commonly ordered in milligrams or micrograms per kilogram of body weight. Below are the steps to determine a safe pediatric medication dosage: Example: Order: Meperidine 1.5 mg/kg IM. The child weighs 20 pounds. Step 1: Convert pounds to kilogram 2.2 lb: 1 kg:: 20 lb: X kg 2.2 X = 20 X = 9.0909 (Always round to the hundredth place for children) X = 9.09 kg Step 2: Calculate the ordered dose of Meperidine. 1 kg: 1.5 mg:: 9.09 kg : X mg X = 13.635 (Always round to the hundredth place for children) X = 13.64 mg Meperidine Now that you know how to determine the amount of medication to administer based on weight, you need to learn how to determine if that dose is within the safe range. Drug manufacturers will include the safe pediatric ranges for medications. You have to insert the dosage for your pediatric patient into the equation and use ratio and proportion, to determine if it is a safe dose. If it is, you administer the drug. If it is not, you call the Rev 05/31/09 1. Weigh the child 2. Convert pounds to kilograms as you did in Unit II. Round to the hundredths place . 3. Calculate the ordered dose using ratio and proportion. 4. Determine if the dose is safe according to the manufacturer’s safe dosage range.
20 ordering physician. Many times a range will be given rather than one specific safe dosage amount.