Insulin usage

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A nurse on my unit recently got an order for insulin for an unresponsive patient. This patient hadn't eaten anything for 24-36 hours, but her FSBS was over 500. Our nurse practitioner ordered 20u regular insulin q hour until her FSBS was below 200. This was at 11pm. The patient had already had 25u on the previous shift. The patient expired at 4:45am, but not before she had been given a total of another 120u regular insulin. Any thoughts?

I wouldn't have done it in a LTC. I would have tried to talk the NP into sending pt to er for evaluation. Yes, even thugh she was DNR. If not I would have asked for STAT blood work.

I agree too many unknowns. There is a phrase............................... "I do not feel comfortable with---- and I would appreciate it if you would come to see pt."

:confused:

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