Help with Pharmacology

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Hi,

I am a first year student nurse, and pharmacology is killing me pretty hard right now. I'm currently doing an assignment right now and one question is asking about her blood glucose levels. I don't really know how to answer the question. It also mentions a sliding scale order (i have no idea what this is, i've looked in my books and online and i can't seem to understand exactly what it is). Same with all the units and values lol. I'd be asking my instructor, but she doesn't reply to emails at all and has no time to help anyone.

Here's the question for more details:

Your patient's blood glucose measurements have been steadily increasing since her admission. Results are: 0730h – 8.3 mmol, 1030h – 9.3 mmol. At 1330h Mr. Hauk's blood glucose is 14.5 mmol. What action would you take based on this sliding scale order?

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Specializes in Med/Surg, Ortho, ASC.

Please change your user name to reflect the fact that you are not yet a nurse. It is illegal in most states to claim a licensed title to which you are not entitled.

In terms of your homework, please show what effort you have given to solving YOUR homework. We are happy to help with homework questions but we do not give out answers. We have already served our time as students. We have no desire to do someone else's homework, but will help shape your thought processes, if you give them.

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Sliding scale orders are protocol glucometer checks , usually before meals and bedtime. You will have standing orders to administer regular insulin to cover the blood sugar level.

I have no clue what 14.5 mmol is, as blood sugar is measured differently in the US. Your action would be to follow the sliding scale orders.

Good luck, it's a jungle out here.

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Specializes in Reproductive & Public Health.

A sliding scale is simply an order for insulin with parameters for dosing based on the pt's glucose level- the actual orders may vary patient to patient, depending on individual factors. Hopefully that helps you get on the right track. This is a very basic concept and HAS to be in your textbook somewhere. I am happy to help if you don't understand the concept :)

Would love to help more, if you want to post your thought process thus far. Your reasoning ability is probably the most important skill to develop in nursing school, so any time you have a question that you can't answer, it is CRITICAL that when you seek help, you first outline your thought process and detail the steps you took to try and answer the question yourself. There will never come a time in your career when you know everything. Knowing HOW to find answers (including consulting others in a professional manner) is more important than actually knowing the answer. If that makes sense.

Good luck!

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Specializes in Public Health, TB.

This link, which is directed at patients, may help your understanding of sliding scale insulin.

Sliding Scale Therapy :: Diabetes Education Online

A sliding scale for insulin directs the amount of insulin given based on their blood glucose level, so the higher their level, the higher the dose of insulin is given.

The original post does not show the insulin order, but if the patient's glucose level is rising, then the dose of insulin will increase.

Your values are in mmols, so my guess is that you are in Canada or the UK. No matter what measurement you are using, the blood glucose levels are rising and need to be treated. If they are increasing despite being treated with insulin, then a call to the provider is in order.

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Specializes in PACU.

This does not sound so much like a "pharm" question as it does diabetes management.

But if you are having a hard time in pharm (and it can be a beast remembering all the side effects, labs to monitor, what can't be taken with garlic or grapefruit juice) I'd recommend

Pharmacological Nursing - Picmonic for Medicine | Ace STEP, COMLEX, NCLEX and MCAT with Picmonic :: Picmonic

You can look at a few with a free membership and then make your own. Our instructor had us make our own picmonics in pharmacology all the time.... and when NCLEX came around I could still picture my GENTamycin (gent=man) that I drew with the big ears to remind myself it's ototoxic.

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Specializes in orthopedic/trauma, Informatics, diabetes.

Sliding scale is a correction dose of insulin for a BG higher than whatever parameters the physician says. Other short-acting doses are mealtime doses and are based on weight of pt (usually). I am not great with converting units (yours is mmols, I am used to the Americanized unit)

You haven't listed the SS order (usually a scale, hence SS), if the pt is NPO or not, septic or not, receiving steroids or not, Type 1 or Type 2, home regimen). Obviously pt BGis going up and needs more coverage. If what is being given is not reducing it, the physician should be notified and the scale changed. Found a converter, 14.4 mmol = 259 mg/dl from 149 mg/dl (8.3 mmol). Intervention is needed quickly or your pt will be on an insulin drip by the end of your shift.

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Please change your user name to reflect the fact that you are not yet a nurse. It is illegal in most states to claim a licensed title to which you are not entitled.

And regardless of the legality, it is against the rules at AN to have "nurse" in your screen name if you are not one.

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