double checking insulin

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hello everyone, i am a new graduate LPN and recently started a job in home healthcare..my question is... we have an order on a client for 10 units Humulin NPH at 8:00 am and sliding scale Novolin R coverage as needed per blood sugar checks 4x daily.. .i saw logged that a nurse gave 10 units Novolin (or documented wrong) rather than Humulin.. i reported it to supervision..but follow-up at this agency seems lacking to say the least..checked drug book and internet...if she really gave 10 units of Novolin rather then Humulin would the patient have shown abnormal symptoms during the day?? thanks for any input..i have such new nurse nerves!!

Specializes in Cardiac Telemetry, ED.
another homecare question while i'm thinking about it...what happens if someone gives lovenox im abdominally?? i know he doubled over in pain the day she did it but i don't understand what happens...i know they say Never give lovenox im but they never go into why??? just wondered

Heparin will cause hematoma if injected IM.

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Specializes in Cardiac Telemetry, ED.
and a blood glucose level of 156 is really not a big deal...

when its over 400 or under 50... thats when you need to sweat it....

:cool:

True. But still they can't just skip a scheduled med. As much as I would like to save my patients a poke when I have to inject one measly unit, I must follow the protocols.

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Just wanted to add to the OP: remember to document the details of the call you made to your agency regarding the incident and keep a copy of this for your own records. Any time you report a discrepancy, you need to document it for yourself as well as the agency. Also document any follow-up. When the agency gets the original copy of your documentation, then they will know that you are not just talking to them to hear yourself talk. What action they do or do not take is not your responsibility. But at least you will have a copy of the paper that states that you informed your supervisors. This is for your own protection, should anyone question your actions in the future.

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Specializes in Emergency, Trauma, Flight.

yup yup nancy.. they should NEVER skip a scheduled med...

i never said that they should...that would be wrong...

:cool:

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Specializes in Emergency, Trauma, Flight.

oh... and nancy is right... lovenox should NEVER be administered IM... that order was written wrong..... lovenox is a form of heparin... very good at dvt prevention....

its not TPA... its not a clot buster.... but... it does *thin* the blood...

listen to nancy... she knows what she is talking about....

:cool:

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Specializes in Cardiac Telemetry, ED.
yup yup nancy.. they should NEVER skip a scheduled med...

i never said that they should...that would be wrong...

:cool:

I know, didn't think you were advocating skipping meds. Just wanted to clarify.

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