Was I wrong to hold Insulin? - page 2
I had a bood sugar check of 75 during the 5:30 check. I was supposed to give 6 units of Novolog and there was no hold order in the MAR. I consulted 2 other Nurses on the floor who agreed the blood... Read More
0Jun 2, '13 by Chica_bella813I completely agree you did the right thing by using your judgment. I think its ludicrous for your superior to tell you to give a milkshake while giving her the insulin. this is an elderly woman, her body will metabolize things a little slower and eventually it would have caught up with her in a negative way. You were also very smart to recheck it. After the recheck I would have called the Md and said this am she was 75 I with held her insulin waited and now she is at 133 are you okay with her receiving the 6 units after she ate 1/3 of her breakfast. Especially with the elderly we have to be very cautious to how they respond to meds. Kudos to you!
0Sep 13, '15 by PvidaThank you Anne36 so much for reminding everyone ...just like a patient is not a room number! :-) They have names and should be used!Last edit by Pvida on Sep 13, '15 : Reason: forgot to put senders name
0Nov 1, '15 by MudwomanAs nurses, we think that because we have a brain and we can think, that gives us the right to stretch that line in the sand when it comes to what we can LEGALLY do and what CRITICAL THINKING says we "should" do. The reality is that you do not have the scope of practice to ignore a doctor's order. If your critical thinking skills say that insulin probably should be held, then call the doctor. Only the doctor can give you the order to hold that insulin. I know it is a pain to do that; especially if you are chasing 7 diabetics, but nurses can not decide to hold a medication. There has to be a doctor's order to do so or standing orders from that doctor that if the patient is eating less than "x" % of their meals and their blood sugar is less than "x", hold the insulin. You could get such an order for this patient and save everyone (including the doctor) calls every time someone decides insulin is not such a good idea.
Basal insulins such as Lantus and Levemir are never held.
Treating a low blood sugar requires giving ONLY a food with carbs. Never give any food with fat in it as fat slows the absorption of carbohydrate (glucose). Once a blood sugar is stable, giving a protein with a carb will help keep that blood sugar stabilized.