Managing blood sugars and insulin dosage

[dcurry]

Can anyone tell me what happens if capillary blood sugars are checked AFTER the patient has eaten their meal. I know ideally they should be checked and Novolog given 5-10 minutes before they eat. This seems to be a next-to-impossible task on our very busy surgical floor. If blood sugars are checked after patients eat what do I do about their insulin...hold, give anyway? How do I know they won't bottom out? New nurse deb.

[Tweety, BSN, RN]

It really depends on how long after the meal is eaten what is going to happen. If it's right after or even during, I would guess it's not going to really be an issue.

How do you know they won't bottom out? You don't unless to check another BG.

You should also be concerned with hyperglycemica because the patient is eating without any insulin. If they drink a juice or food that raises BG rapidly, you are playing havoc with their bodies.

I understand how busy med-surg is and it is next to impossible if you have many accuchecks. We just hold the trays and make the patients with accuchecks wait until they eat.

[BigBee48]

I agree with Tweety, no matter how busy you get, you must make checking BG and giving their insulin priority. It will truly mess their BG and systems up. Also you are setting a bad example for them

when they do return home, they may think the nurses didn't really make it priorty, so I can check it whenever

I have time or remember. We always held trays until that was taken care of, just make that priority. There is so

much to learn as a new nurse, but my Mom is diabetic, and she came home tried not to make checking her sugar

a priorty, and sometimes she would say, "I forgot, I will check it later, or I'll take my shot later with supper, or tomorrow". Anyway make it priority.