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 sugar was too low and I held it. This is an elderly lady with an unreliable appetite. Later on in the evening I went and checked her blood sugar again and it was 133. (was I even wrong to recheck? mabye) The next time I went into work the care manager for the unit told me that I should have called the Dr if I was going to hold her insulin for under 100. She also said that I should have given her regular Novolog and given her a milk shake. What if she wont drink the milkshake? I dont have time to chase 7 Diabetics all over the place watching everything they eat and drink. I did the check when I was supposed to and it was low, so I held it. What do you think?
I would have held it; however, make sure you follow your facility's policy. Where I work, we have a standing order to hold all pre-prandial insulin if the blood sugar is </70 but we still need to notify the doctor. We ALWAYS need a doctor's order to hold insulin and this needs to be documented. A patient's blood sugar may be 82 so they may not get coverage but they may have some Lantus scheduled...say, 20 units at bedtime. We still need to call the doctor to see if they want us to hold it or at least adjust the dose. You also weren't wrong to recheck the blood sugar; I would have done the same thing, especially if the patient has an unreliable appetite.
Last edit by turnforthenurse on Dec 5, '12
: Reason: typo