Blood Glucose + GT + Lantus question

Key_ · Nov 15, 2009

I think it depends on a lot of things. Like how much lantus and how much are they used to getting? What are their trends like after they get the lantus? If I have a patient with a blood sugar less than 100 I always go back and see what their blood sugars have done in the past. I would rather hold the lantus and have to treat the higher sugar later than have someone bottom out on me. But there are nurses on my unit that give the lantus no matter what and swear by it.

mamamerlee, LPN · Nov 15, 2009

The 'npo' here is a technicality - -the patient is still being fed. It would seem from your brief amount of info that the Lantus is doing its job - holding the BS to an appropriate level.

Now if you mean that the pt's feedings are stopped, that is a different ballgame.

mlok · Nov 15, 2009

Thanks for your response. I was at work today and I am a new grad. My pts BGL was 82. He is NPO on a constant GT at 75ml/hr and had an order for 50 units of lantus. I thought that was really excessive, especially if his current BGL was 82 I know lantus onset is about 2-4 hours and it last for 24hrs. But I was still worried. I asked other nurses and they said to give to him because was a GT tube. He was a new admit so I didn't have any previous BGL to go by. He's nonverbal and can not move so it's not like I could have asked him about his history. I called my job a couple minutes ago and told the nurse I was worried about it and asked her to check his BGL and she said it was 220. So I feel better about the situation. I gave him the lantus at about 11p and called at 2am.

Ruthiegal · Nov 15, 2009

Lantus is a slow acting insulin acting almost as a basal insulin. I would give it at 82. If you were concerned a call to the physician would have been a good idea to see if he wanted it held. 82 is a normal blood sugar. If he is on continuous feed and you hold it, he will go too high, and then it takes time to bring him back into a normal range.

I say this out of experience.

ilovenursing2009 · Nov 15, 2009

mlok! I recognize you from the mollen thread; CONGRATS on getting a job that is great news!!! No more mollen BS!!!!

cardiacmadeline, RN · Nov 15, 2009

I would have given the Lantus. You should never hold Lantus without a doctor's order. I have had endo tell me to give it (a lower dose then ordered) with a patient's blood sugar in the high 60's. And yes I gave it and the patient was fine. Of course, I did give him a snack with that low blood sugar also. As a previous post stated, if you don't give the Lantus you will be treating high blood sugars later.