HOSPITAL POLICY
1. Remove new vial from Pyxis
2. Label vial with patient label and "FOR TEACHING ONLY" label
3. Take vial and syringe in patient room for teaching
4. When completed, dispose syringe and return to vial to pyxis specific bin
What is correction insulin used for?
Used to correct blood glucose levels that are higher than the target range.
When does the steroid usually peak after the dose is given?
Dexamethasone, Prednisone
Usually peaks 4-8 hours after dose
What type of regimen will TYPE 1 patients ALWAYS need during admission?
Basal/Bolus, Correction
If a patient requests or requires a snack, what steps will you take to provide appropriate snack?
Refer to the Unit Snack List to determine an appropriate snack based on the patient's CBG level.
What is the duration of action of Lantus (glargine)?
24 hours
When during pregnancy does insulin resistance increase d/t placental hormones?
second and third trimesters
Patient T.H. has Type 1 Diabetes and is NPO for a procedure today.Pt has AM Lantus 30 units scheduled. His AM blood sugar is 180 and his mid-day blood sugar is 95. He went for his procedure and returned at 1700. A diet is ordered for him for dinner.
His blood sugar prior to dinner is 75. Does this patient need a full mealtime bolus dose?
YES
Since switching to community vials, how much money has the hospital saved?
$1.5 million
TRUE OR FALSE
For NPH insulin, the AM NPH dose is reduced by 50% on the day of the surgery. No changes to the PM NPH dose.
TRUE
Holding basal insulin for a patient with Type 1 Diabetes can lead to what?
DKA
T2DM - poorly-controlled with A1c >9% and BG >200
What type of insulin regimen will likely be started for this patient during admission?
Basal/bolus, correction insulin
Where can you go to find the discharge milestones in EPIC?
Navigator
Care Plan
TRUE OR FALSE
For Lantus insulin, the dose is reduced by 5% either the night prior or morning of surgery.
FALSE. 25%
Mr. Garza is a 67-year-old male with PMH of DM-2, arthritis, HTN, HLD and TIA. He is on continuous tube feeds. Patient takes NPH 20 units BID and Regular insulin 16 units q6 hours for tube feed coverage.
You are alerted that patient’s tube feeds are being held now for EGD procedure tomorrow.
What should you do with the NPH dose and the Regular insulin doses?
Reduce NPH to 10 units BID
Hold scheduled insulin and administer correction dose only.
Open kit, set up time, date and language. Assemble lancing device, use test strip and allow pt to check own BG
What is the ideal blood sugar target range for non-critical medical/surgical units.
Maximal- less than 180
How long was the longest fast by a human?
382 Days
Ms. James is a 32-year-old female with type 1 diabetes mellitus admitted with sepsis. She is on stable dose of Glargine 22 units at bedtime and Aspart 7 units TID. Order placed for NPO past midnight. Bedtime BG is 91. What do you do with the evening Glargine dose?
GIVE IT!