Do you ever hold Lantus?
- 0Nov 15, '12 by SleeepyRNMy understanding is that you do not hold lantus. (Im a new grad just started in LTC). BG WAS 126 after having dipped tp 67. I raised his glucose to 126 and administered the Lantus. Im an RN, and the oncoming nurse was an LPN. He was irritated with the fact that I gave the Lantus. I respect LPNs experience and I do learn from them, but there is a reason why RNs are needed. That last year of nursing school, you grow and learn so much that LPNs do not get in the LTC setting. What are your thoughts on holding Lantus?
- 4Nov 15, '12 by Sun0408Generally speaking, no I don't hold lantus. However, the 126 was after treating from a previous low level. This would have me asking, is the lantus too much, how often are they dropping, are they eating regularly ? If this is a problem, I would call the MD or PCP and state the facts, pt is not eating well, frequent drops in BS over several days/weeks and let them decide.
The pt may need a change in the lantus or a decrease in sliding scale.. If this was a one time issue, I would tx the low levels, give the lantus and monitor while encouraging meals. OJ and crackers will only bring them up for so long.
- 0Nov 15, '12 by misha22I wouldn't ever hold Lantus! It is a long acting insulin so if you withheld it it could lead to high BGs and possibly ketones depending if they are producing any insulin on their own or not. if the patient doesn't produce any insulin on their own, withholding their basal insulin dose (Lantus) could lead to ketoacidosis!
- 0Nov 15, '12 by Nurse_AVI think you were right to give the Lantus unless, like Sun0408 said it is a chronic problem. At which point the resident's BGs and insulin therapy should be reviewed by the doc. I am an LPN working in LTC currently, I don't believe I've ever held Lantus. Since there is no peak with Lantus it is not an insulin that would suddenly drop blood sugar. And also I agree with you that we do need more RNs in LTC! I'm going through LPN/RN transition right now. I work with a lot of RNs on a rehab unit and it's wonderful to work with such great nurses. That's what prompted my return to school.
- 1Nov 16, '12 by classicdame GuideI never hold Lantus. It is a policy in my facility to always give it. The body needs insulin 24/7 and this is the insulin the patient is needing to maintain normal function. It is not the same as regular or fast acting and does not affect a specific meal. It will not lower the glucose level enough in a few hours to be significant. If you do not give it then normal body function will be impaired, including brain function.
- 0Sep 4, '13 by mammac5Right, don't hold the Lantus but DO communicate concerns to the prescriber. If the basal insulin is prescribed correctly - to cover the body's need for insulin regardless of CHO intake - then the blood sugar should not be dipping low even when NPO.
On a side note: Remember that Type I and Type II Diabetes are two very different disorders. A person with Type I DM can go into DKA very quickly when basal insulins is held.