Insulin question

[Shagce1]

Hi-working on a study guide for pharmacology final exam.

Question: A client accidentally administers 100 units of Regular-short acting insulin instead of 10 units. How long should the nurse monitor the patient to assure the client is no longer at risk of a hypoglycemic event?

I know onset would be 30-60 minutes. Peak is 2-4 hrs and duration is 6-8 hrs. My gut says monitor the full 6-8 hours. But would monitoring through that 4th hour be sufficient as it should have peaked and effects should be lessening?

Thanks for any help.

[RN403, BSN, RN]

I would monitor through the full duration of the drug (6-8 hours). True, it is most important to monitor a patient during the peak of insulin as this is the period in time where they are at the highest risk for hypoglycemia, but, you would still continue monitoring the pt for the full 6-8 hours duration of insulin. Especially if a med error was made where they were given 100 units instead of 10.

I would even have a bolus of Dextrose on hand in real life...and lots of OJ.

[Lev, MSN, RN, NP]

Your gut is right - go with your gut. You would probably monitor for the full duration of the insulin + longer. I would be checking blood glucose q1-2 hours if that was my patient.

[Esme12, ASN, BSN, RN]

That is A LOT of insulin...I say the full 6-8 hours

I've actually had a couple of these patients (one regular and one who gave herself an entire pen of Lantus). We didn't monitor based on the published pharmacokinetics, we monitored until the sugars normalized. The regular insulin took about 10 hours while the Lantus took about 36 hours.

[Shagce1]

Thanks everyone! That is what I was thinking...just wanted reinforcement in my judgement!