An order reads Nobilin N 37 units and Nolin R 5 units and No

An order reads Nobilin N 37 units and Nolin R 5 units and Nolin R 5 units\' sub cut stat. Suppose you draw up 37 units from the nonvolant R vial and 5 units from the nonvolant N Vial Although the patient receives 42 units of insulin, he receives a much larger dose of regular (shorter-acting) insulin than was ordered -37 units rather than 5 units. The insulin, metabolizes the patient\'s glucose too quickly; he becomes hypoglycemic and loses consciousness; this could lead to brain damage and death. Fortunately, the hypoglycemia is noted in time so glucagon and 50% dextrose are administered and the patient recovers. This error can be avoided if you carefully check the order against the labels three times, and the patent recovers. This error can be avoided it you carefully check the order the authorized prescriber ordered a routine dose of NPH insulin 15 units; at and a pm dose of regular insulin 4 units at 0730, if the patient s co 9 \' 140. The patient\'s 0730 blood sugar is 141. What type or types of insulin should be administered? What is the total dose of insulin to be administered? What syringe should be used to administer the insulin? What might happen if you gave the insulin at 0730 and the breakfast tea was delayed until 0930? What could you do to prevent this from happening?

Solution

1.Two types of insulin including long acting insulin (NPH) and intermediate acting insulin dose should be administered.

2. NPH should be administered 15 units at 7.30 am and regular dose of 4 units at 7.30pm. Total 15 +4 = 19 units.

3. Normally U - 100 syringes are available to administer insulin. Some syringes can be used with two types of insulin.

4. If insulin was given at 7.30 am and breakfast delayed till 9.30 am, the patient may be low in his glucose levels or become hypoglycemic nd may lose consciousness. In such cases, glucagon and 50% dextrose must be given immediately to prevent brain damage and death.