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 tosliding scale below. The patient’s blood sugar was 235. Howmuch insulin will the nurse administer?Based on the above sliding scale, you administer 4 units.Practice Problems # 18Use 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 29-31Rev 05/31/09POINTS TO REMEMBER WHEN ADMINISTERING INSULIN1.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 Insulin0 – 150 No insulin151 – 200 2 units201 – 240 4 units241- 280 6 units281 – 330 8 unitsover 330 Call MD
19of 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 DOSAGESInfants 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 kilogram2.2 lb: 1 kg:: 20 lb: X kg 2.2 X = 20X = 9.0909 (Always round to the hundredth place for children)X = 9.09 kgStep 2: Calculate the ordered dose of Meperidine.1 kg: 1.5 mg:: 9.09 kg : X mgX = 13.635 (Always round to the hundredth place for children)X = 13.64 mg MeperidineNow 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 05/31/091.Weigh the child 2.Convert pounds to kilograms as you did in Unit II. Round to the hundredthsplace.3.Calculate the ordered dose using ratio and proportion. 4.Determine if the dose is safe according to the manufacturer’s safe dosage range.
20ordering physician. Many times a range will be given rather than one specific safe dosage amount.