Insulin while NPO? - page 2

Silly question: would you give insulin to a patient who was NPO before surgery? It seems like the answer could be obvious, but I am feeling a little guilty. Scenario: Mr. Smith was an elderly, diabetic patient admitted at 3am for... Read More

  1. 0
    I think your charge nurse was correct. When I worked the floor, our sliding scale protocol only covered HS CBGs >200 (or was it 250?). An HS CBG of 185 would not have received a sliding scale dose.

    Long acting insulin such as Lantus would be a bit different, since they are supposed to be peakless. If the patient is receiving dextrose containing fluids, then the admitting doc might want them to get their long acting insulin.

    The patient will most likely be coming out of surgery with some sort of IV insulin protocol in place until they are taking P.O.

    In conclusion, I wouldn't worry myself over an HS CBG of 185 on an NPO pre-op patient.

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  2. 2
    I agree that it is always safest to ask the physician in situations were the patient is NPO for surgery and has a high BS. HOWEVER, 185 is not worth waking the doctor up. You did the right thing. If the BS was > 200 I would have called, though.
  3. 0
    I agree, doc has final word. Be your patients advocate though and request that at least partial dose of BASAL is given, maybe even give the whole dose depending on procedure time, insulin resistance,past blood sugars following NPO status. After all, their bodies are not making enough of it, they need their insulin!
    Obviously hold pre-prandial dose since they are NPO.
    Personally, I would give the sliding scale coverage as well. If you're NPO and your BG is greater than 250-your patients body will suffer high or low, and a stble bg prior to a procedure is a must!


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