The authorized prescriber AP ordered Humulin insulin 20 unit

The authorized prescriber (AP) ordered \"Humulin insulin 20 units now.\" The healthcare practitioner, unaware that Humulin insulin is available in both regular and NPH forms, administered Humulin R, regular insulin, at 5 p.m. At 8 p.m. the patient experienced symptoms of hypoglycemia with a blood glucose level of 42. The blood sugar was treated with orange juice and food and rechecked until it was normal (which occurred within 1 hour). The next morning, the fasting blood sugar was elevated, so the AP increased the dose. Again the patient experienced a low blood sugar at bedtime and a high blood sugar in the morning. What error did the AP make? What error did the healthcare practitioner make? How could the healthcare practitioner have prevented error? Why was the patient\'s blood sugar low bedtime? Why was the patient\'s blood sugar high in the morning?

Solution

1.

2. He should have been aware of 2 types of insulin and their mode of action.

3. If the health care practioner administered insulin NPH 20 units it would have reduced blood glucose only after intake of food . But the regular insulin decreased the blood glucose before the food is converted to blood glucose.

4. As the blood glucose is reduced before metabolism of glucose and generally diabetic patients doesnot have food rich in sugars blood glucose cannot attain normal and hence he experienced low sugar at the bed time.

5. After taking orange juice , sugar attained normal and he expeienced high blood sugar in the normal.