Timing is Everything
You have this much time after checking blood sugar to give correction insulin
60 minutes
NPH is this type of insulin
intermediate acting
The medication rapidly shifts potassium into cells
insulin
What blood glucose level defines hypoglycemia
<70mg/dL
This occurs when multiple doses of rapid-acting insulin overlap, increasing hypoglycemia risk
insulin stacking
In this situation you would hold nutritional insulin
Patient is NPO or not eating.
Peak action time of NPH insulin
4-12 hours
Insulin for hyperkalemia must be given with this medication to prevent hypoglycemia
dextrose
Critical value for low blood glucose is defined as:
<50mg/dL
Rapid acting insulin typically lasts this long in the body
3-5 hours
The peak effect of lispro insulin is:
0.5-2.5 hours
This medication is commonly linked to NPH in the MAR
prednisone/ steroids
Blood sugars must be checked how often after treatment with dextrose/insulin
Q 30min x3, Q 1hr x3
This medication is given if the hypoglycemic patient is unconscious or NPO
IV dextrose or glucagon
Giving correction insulin too frequently (every 2 hours) can lead to this dangerous outcome
hypoglycemia
You have this much time to recheck a fingerstick in order to "throw out" the bad sample.
5 minutes
Ex. Fingerstick is 19, recheck within 5 minutes on earlobe to not have low BS 'counted' in Eden metrics
Where can you find NPH insulin?
pyxis multidose vial
This type of insulin is used IV to treat hyperkalemia
regular insulin
How often must blood glucose be checked after treatment?
every 15-30 minutes and until >80mg/dL
Best practice: wait this long before re-dosing rapid acting insulin to avoid stacking
3-4 hours
Name the time windows for CHO trays to be delivered from the kitchen – (hint 1 hour window for each meal)
breakfast 7:30-8:30
lunch 12:30-1:30
dinner 17:30-18:30
Name an indication for giving NPH insulin you may see in the MAR
peritoneal dialysis
also steroids - but really looking for PD
What is the occurrence of hypoglycemia following treatment with insulin/dextrose?
10%
Name the snack given to dysphagic patients after initial treatment if the meal is greater than 30 minutes away
pudding
What ancillary department can you call for assistance with retiming insulin?
pharmacy