Pt safety concern: Lispro vs Regular

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  1. This is a discussion on Pt safety concern: Lispro vs Regular in Nursing and Patient Medications, part of General Nursing ... Im a nurse working (with usually 4-5 pts) and got floated to snf (9 patients). Ive been scrambling...

    by Aug 21, '11
    Im a nurse working (with usually 4-5 pts) and got floated to snf (9 patients). Ive been scrambling back and forth with pain meds, ivmeds, 1tube feeding and..5 Blood sugar checks.. I have a pt on tube feed (60ml/hr) continuous and is on blood sugar check bid. I checked it and it was 212. I gave 6units on the abd per protocol. Problem was, i gave the lispro instead of regular. im really worried that the 6 units will have an impact on this pt with tf? Is there a huge difference between the 2 insulins when it comes to ppl on continuous tf? I tried doing some research but didnt find any help? Advice greatly appreciated.
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    by Retrox24 Aug 21, '11 4:14 am
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  3. 9 Comments so far...

  4. Aug 21, '11 by
    I doubt there would be a problem. Lispro peaks in 30-90 minutes, and has a duration of about 5 hours. It just works a little faster than regular, but if you are worried, just re-check the sugar. Six units is not too much for a blood sugar of 212, esp. with continuous feeds.
    pinkchris2000 and Retrox24 like this.
  5. Aug 21, '11 by
    Quote from applewhitern
    I doubt there would be a problem. Lispro peaks in 30-90 minutes, and has a duration of about 5 hours. It just works a little faster than regular, but if you are worried, just re-check the sugar. Six units is not too much for a blood sugar of 212, esp. with continuous feeds.
    Thank you so much for that info. I think i just needed some reassurance that the patient wont get hypoglycemic, and youre definitely right. It makes sense. My brain just did a double take because i realized what had happened when i was already heading home..and to think i had another nurse double check it. I dont remember what went wrong (perhaps giving insulin to 5 patients including lantus did it)... And i now have greater appreciation for my own unit after floating to snf. Im not used to 9 patients... Definitely dangerous and at high risk for med errors.. I dont know the regular nurses there do it.. Thanks again!
    Last edit by Retrox24 on Aug 21, '11 : Reason: Spelling
  6. Aug 21, '11 by
    In a pinch, I can interchange them (on myself ), with no problems. I use NovoLog ac, and know that the only thing to really look out for is the onset- but w/continuous feeds, that shouldn't be an issue
    Retrox24 likes this.
  7. Aug 21, '11 by
    Thanks so much xtxrn, i really appreciate that info. Im actually glad the pt is on continuous tf. It makes a big difference to give insulin to a pt on tf vs a patient who is not eating or npo. But ive learned my lesson to take my time with blood sugars, because safety matters! But seriously, im a paranoid worrywart..lol thanks for the advice!
    xtxrn likes this.
  8. Aug 21, '11 by
    That isn't that much insulin for a tube feeder rtc.

    I work LTC that is part sub acute (of course they don't call it that) but mostly rehab. Out of 22 pts, I can have up to 10 blood sugars to check. Most are qid with coverage and include lantus too. PIA. I guess you just get used to it. I would feel weird asking others to check my insulin and got some strange looks when I tried it when I was new. You do get used to be cautious and giving so much inulin and doing all the accu checks.
  9. Aug 21, '11 by
    Quote from michelle126
    that isn't that much insulin for a tube feeder rtc.

    i work ltc that is part sub acute (of course they don't call it that) but mostly rehab. out of 22 pts, i can have up to 10 blood sugars to check. most are qid with coverage and include lantus too. pia. i guess you just get used to it. i would feel weird asking others to check my insulin and got some strange looks when i tried it when i was new. you do get used to be cautious and giving so much inulin and doing all the accu checks.
    thanks for that feedback, michelle. im always impressed at how u guys do it ( handling > than 10 pts) since i have no experience with snf. i work at a hospital and often get floated to other units, including snf. ive floated to that unit a few times and they always call another rns attention for the insulin they are giving.. but after reading some posts from this website, it really defeats the purpose to do it when they dont show the order, and there are too many patients to really take the time to meticulously check the whole 5 pt rights. thanks again for your perspective
  10. Aug 21, '11 by
    Although no harm was done, you need to be sure to report the error. This will ensure that other nurses can use your experience to avoid making the same error.
    Retrox24 likes this.
  11. Aug 22, '11 by
    Definitely, thanks Schatzi!
  12. Aug 23, '11 by
    No biggie OP. Now, if you gave 30 units of Lispro, instead of 30 units of Lantus or Levamir, you and the pt would be in trouble