Oral diabetic Drugs

[silverhalide]

I have a question -- need advice -- some of the diabetic stuff is still really confusing. I had a patient last night, was sent out to the hospital at 3:30 -- is on Metformin and Glipizide which he was to get at 4:30/5 before dinner. His meds were not sent with him and he did not get the metformin or glipizide. He was back at around 7:30 -- he did not eat dinner. I tested his BS and it was 112. Spoke to my supervisor and he said not to give him the metformin/glipizide, worried about him bottoming out. He was eating ice cream. I agreed, seeing he didn't eat that much, but I also didn't feel like his sugar was that low, plus he was having a snack -- or it warranted a call to the doc. (and he was supposed to get the meds at 5)

Advice?

[alfrnbsn1988]

I would have given him the drugs. Have you ever given a patient a orange juice for, let's just say, a blood sugar of 50 and 15 mins later his sugar was back up to 70? Well that's the same case with the ice cream, unless it was sugar free. After that ice cream the blood sugar could of been above 200. So it's 10:00 at night, your patients on lantus, let's just say, which works slowly. The patient is never in a normal range now, causing a spike in the morning. I always say hold for less than 90

[silverhalide]

That's what I thought as well --

[Salisburysteak, BSN, RN]

In your report from the hospital specify if this resident had any meds while in the ER? Any new orders from the physician? Did you tell the ER that his 5pm Metformin/Glipizide was not given yet? Technically, it was too late for you to give his 5pm meds. On the back of the MAR there should be some codes to put in place for a reason a med was not given. Being in the hospital is a good reason.

Just my input!

[happyinillinois]

It is highly unlikely that the ER will give 5pm oral diabetes meds, especially if the patient returns to the facility at 7:30 pm. The ER does not give routine meds unless the patient is admitted or there for quite a while, and this is not the case.