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Discussion

Diabetic orders

So, bearing in mind that I'm a sub give me some insight into this: T1D orders are for her carb total to be divided by 20. that's her insulin dose for the meal, added to that is

BG -120____ and then you divide that by 50 and add the result to the insulin dose as a correction factor.

So one day I find that the other sub had divided the result of the BG -120 and she had divided it by 20 instead of 50, so I wrote her a note and she said she asked Mom and was told that the correction factor can change...but if you divide something by 20 instead of 50 you will get a much higher result.

Further, the orders from endocrinology state that the correction factor should be 50...

My "nurse sense" is most unhappy and I'd love to know what you guys think, I hope my explanation was clear.

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    All of our T1D orders state that parents may make changes. That being said, I have never had a parent make that big of a change. I think I'd be checking with the endo.

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    Or at least run it by parents to verify.

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    See the other sub did that...I can't take phone orders so calling the endo office isn't in the cards. I've got the willies about this but I've been lucky so far, she hasn't needed the correction factor. It'll be a year before she gets a pump, I've dealt with lots of pumps, but only one other student with injections (pen) and then the primary nurse had it ALL laid out on a chart, no changing ratios just if X carbs than Y insulin, if BG=A then add B more insulin to Y.

    Additionally what this Mom says we do, I'm not sticking anything into that hornet nest! I just worry...

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    My orders say that parents can adjust as needed, and I always document that the change was as parent directed. What was the student's outcome when the higher dose was given? Is there a follow up blood glucose on the record? That's a pretty big difference.

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