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Discussion

Medication Question...

A couple of weeks ago I came across an NCLEX practice question that specified giving Insulin with an IV drip in a nondiabetic patient. I did not understand the rationale and asked my clinical instructor. She clearly understood the question, but had a difficult time explaining it so that I could understand or else she did fine and I was just having a dim moment. HA!

Today I rotated into ER and I was giving a patient Kayexelate and Calcium Chloride. The nurse was telling me something about giving insulin because glucose follows potassium and then he would administer glucose but counter that with the insulin to try to maintain optimal blood sugar levels.

Now....my question is, are these 2 related...meaning the NCLEX question and the meds today in ER.

I understand that without the specific NCLEX question it will be hard to answer this question...but any additional information that I can get as to why insulin would be given to a nondiabetic patient and if the information from ER is correct. I am sure the nurse knew what he was talking about...I am just not sure if I retained the correct information. I did not have a chance to write down what he was saying. Either way...it struck a chord with me concerning the earlier question I had and I am still really foggy on this subject.

Many thanks in advance.

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http://www.emedicine.com/EMERG/topic261.htm

Drug section: antidotes

From Harper's Biochemistry, 25th ed, p616:

"Insulin also promotes the entry of amino acids into cells, particularly in muscle, and enhances the movement of K+, Ca++, nucleosides, and inorganic phosphate. These effects are independent of the action of insulin on glucose entry."

I work for a neurosurgeon and we use an Insulin drip on almost all our surgery patients. You have to remember that patient's under stress will sometimes have elevated blood sugars. When the glucose is high infection is high. Therefore we use the drip to keep glucose WNL and in turn low infection rates. Whether or not our patient's are diabetic they almost all will have an insulin drip. Hope this was helpful.:nuke:

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Thanks for the replies.

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