Caught a bad insulin error today

[mustlovepoodles]

I'm a school nurse(elementary) so I have contact with our students with diabetes several times a day. One of them is young and her sugar has been very labile. She can come in at 8:15 at 389 and by lunch she's down to 70 or below. She comes up at lunch(I actually give her insulin AFTER lunch so I can look at her tray to see how many carbs she actually ate--she's a picky eater.) I check her BG correction, then her carb correction, then give the insulin, which I triple check. It is not uncommon for her to be back in teh clini within 2 hours, somewhere around 49. This kid scares the bejeezus out of me!

Okay, today was the final straw. Another very low episode after lunch. I even went back and rechecked the insulin dose thinking that maybe I had done something wrong? Nope. In fact, when i went back and looked she has had EIGHT low episodes in the past 10 days!(I've been out since last week.) Holy cow! I picked up the phone and called the doctor direct(usually, we get orders via the parents). She asked me to read her lunchtime carb correction--18 carbs per 1U insulin. "What? That's not right! Its FORTY carbs per 1U insulin!" All-righty then. I'm looking right at the original doctor's order and it very clearly says 18. This kid has been getting TWICE the insulin dose she should have for the past 2 WEEKS. OMG! It's a wonder we didn't kill her! I faxed the orders, the consent to contact, and all her logs for the past 2 weeks. I fully expect new orders on my desk in the morning. If not, we will be having another pow-wow, because I am NOT going to follow this order one more day! :mad:

[morte, LPN, LVN]

Sorry Guys,

I did not mean to imply that ADHD does not exsist or that it needs to be treated.

And I Absolutely did not mean that I believe that it is caused by bad parenting.

Case in point-my 7 year old grandson is AHDH and takes meds and yes it helps.

What I ment was-I had an exceptionaly high number of kids on these meds for the size of the elementary school. And when my kids were little there were far fewer cases.

And actualy, I dont believe that the ADHD kids who were not medicated grew up to "flip hamburgers or pump gas"...think of Robin Williams-he's self admitted ADHD and there are many more extremely successful people...so, Alicia, I'm not sure where you are coming with that one.

So, now back to the original topic...

Mea Culpa,

s

i was going to say the same thing, that you hadnt said that any one child shouldnt be medicated, but the number that you saw was out of proportion to the total......i actually thought it was rather clearly stated.

another example of success would be Ansel Adams....though his father took him out of school fairly young.

[classicdame, MSN, EdD]

that is why you are in that position - to advocate for the patient. Blood sugars change hourly, not every 3 months when doctor visit is due. YOU ROCK!!!

P.S. Recommend you print out the recommended pedi doses (adult if kids over 70 kg) for reference.