Is this covered? How many units would you give?

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Specializes in Peds ED, Peds Stem Cell Transplant, Peds.

The insulin ordered reads 1u of Novalog for every 100 points over 100 blood sugar. Give 1u per every 25g carbs.

The blood sugar was 470, carbs eaten 79g.

Dose I administered was 6u.

Coworkers are suggesting I give 6.5u. I disagree because there was not order for the .5u, and rounding up was never ordered.

BTW I am new and don't know the endocrine doctors that well, to assume anything.

What do you say?

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I think you did the right thing. I take much more than that, but each person is different. Have you rechecked the pt's sugar yet?

Best wishes - you are doing just fine!

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Specializes in Peds ED, Peds Stem Cell Transplant, Peds.

This was a petite 8yr 18kg peds patient

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Specializes in Hospital Education Coordinator.

I agree with you. ALways better to under dose and go exactly by the MD order. BTW, the MD order is not really clear anyway. Give per glucose level or by carbs? I generally recommend a FIXED dose of rapid acting at meals PLUS more if level greater than 120. This is per ADA in-hospital treatment recommendations, but of course every patient has special needs. I still agree with you

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I think the way the order is written includes what we would call at the hospital where I work Meal+Correction. The correction is for the high CBG and then the meal order is to cover the carbs that will be consumed. It is worded in a way I'm not familiar with, but I see where they're coming from.

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You did right kidrn911. Give insulin in whole unit doses, not rounding up, unless MD notes otherwise.

Worst thing that will happen by not giving the extra .5u is that her blood sugar will be slightly higher at next reading.

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You did right kidrn911. Give insulin in whole unit doses, not rounding up, unless MD notes otherwise.

Worst thing that will happen by not giving the extra .5u is that her blood sugar will be slightly higher at next reading.

Like mammac5 said, this is meal+corrections dosing, which is what most type 1 diabetics (and some insulin dependent type 2s) do to manage blood sugar.

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