I'd really appreciate it if anyone could answer a quick question about sliding scale coverage. I'm an RN and just started working LTC night shift. Last night at 2:00 am one of our diabetic residents awoke with pain in her right foot and requested her prn vicodin. After giving the pain med I assessed the foot for circulation motion and sensitivity and found nothing unusual.
So I decided to check her sugar since we were taught in school that this is an independent nursing action. Her BS was 325 and she has orders for sliding scale coverage. My question is can a nurse administer the sliding scale insulin after doing a random accucheck? It seems most ss orders read "acccucheck at 6am and 9pm with sliding scale for BS > 200." Or something to that effect.
She ended up asking to go to the ER because the pain became more severe. The ER doc gave her Demerol and insulin coverage then sent her back. I probably should know this but...if she hadn't gone to the ER could I have administered the sliding scale without waking the nursing home medical director?
I'll ask the DON when I go back to work Wednesday but would appreciate any feedback. Many thanks!!