dansingrn

Lantus is a basal insulin. Basal insulin is NOT adjusted for PO intake, rather, the rapid acting insulins are adjusted based on the carbohydrate content of the meal or snack. Lantus is adjusted based on a pattern of morning glucose readings. If the p...

I'm thinking if the child requires overnight home health and TPN/lipids, he may not be in a situation where he can be responsible for his T1DM care...

Glucose levels that high are definitely not dawn phenomenon. The child needs more insulin overall; I would contact the physician for sure. You mentioned that he gets Novolog per the bolus wizard, he should also be getting a basal infusion. Those rate...

I am a pediatric nurse practitioner working in an Integrative Pain Management department at a children's hospital. We do use Western medicine, but also incorporate massage, aromatherapy, diet, stress management, self-hypnosis, relaxation/meditation t...

I went to a (mostly) online NP program. It required a GRE and a master's thesis before a panel of tenured faculty. The program was through a state university, and the professors were from the university's school of nursing, all PhD nurses. I don't un...

It's fine to prefill syringes with NPH, home health nurses have been prefilling for their patients who are blind or have dexterity problems for eons. It's important to remember with NPH that the suspension must be mixed as evenly as possible before f...

This is a question that even the insulin manufacturers struggle with. There are several factors, such as number of injections per day (number of times the rubber stopper is penetrated), temperature, sterility, etc. that can affect (however slightly) ...

Omitting insulin causes the body to use fat rather than glucose for an energy source. Fat metabolism creates ketones (acids in the blood). Ketones cause nausea and vomiting, so that be one cause of nausea with missed insulin doses. Rapidly changing g...

blood glucose 2,217

Finished my NP at 49. And I was not the "oldest kid in the class" by a longshot!!! Do it!

Standard sick day management is to treat the hyperglycemia, adding even more insulin if ketones are present (even if NPO, even if vomiting!). Definitely needs insulin in presence of infection, so clarification with the provider is indicated here.

np2b - Do you have peds RN experience? PM me . . . I have a lead on a PNP position in your general region if you are willing to consider a subspecialty in a children's hospital.

I'm an NP in chronic disease management. I work in peds with type 1 diabetes. (The answer is NOT ALWAYS fnp!!) The time to work on preventing complications is at diagnosis. Therefore, working in peds (as a peds specialist, not the broader fnp) hopefu...

Try University of Missouri (Columbia) Sinclair School of Nursing.

Absolutely this tech cannot be required by an employer to revert to injections! Contact the American Diabetes Association for details regarding discrimination against persons with diabetes.

I too am "peds through and through". Many advised me to go FNP for broader opportunities, but when looking at FNP curriculae I couldn't even get excited. When looking at PNP programs, I couldn't wait to take all of it. Although the FNP prepares you ...

I'm peds all the way. No white lab coats.

I finally solved my own organization problem with a small zippered "document case" made by Samsonite. Found it at TJ Maxx for 5 bucks, and its great! Currently in the case: iPhone, keys, calculator, pens, script pad, lip balm, business cards. There i...

Type 1 DM is an autoimmune disease, and can be diagnosed at any age. Just because a patient takes insulin, even from the beginning, does not make them necessarily type 1. Autoimmune beta cell destruction is type 1 diabetes. Many type 2s need insulin ...

Another option that is very popular with my pediatric patients is to place the site on the back of the upper arm with the tubing pointing toward the underarm. The tubing goes down the inside of the shirt, and the pump clips on the waistband. The tubi...

In my institution, we have PNPs as well as a few FNPs, but the preference is definitely PNP. When I was asking myself "FNP or PNP" my only vote for FNP was the "marketability." In the end, I went with my heart and chose PNP and am so glad I did. Even...

I have copied/pasted the required practice experience section from the NCBDE, the body who gives the CDE exam below. NTPinky, you are correct, one must have 1000 hours and 2 years experience in a position whose job description is specifically "diabet...

To work with pregnant women and deliver babies, certified nurse midwife is the track. CNM opportunities can be limited depending on what part of the country you are in. Family nurse practitioners can see all age ranges. If you really truly want to wo...

Why a 90 degree angle with Lantus? Just curious. Loved your thorough answer, and thoroughly agree with all of it. I was too tired to post all that, but I was thinking about it when I read the original post! Saw a type 1 new onset in DKA last month (d...

It seems strange that the FNP requirement is 500 hours for the entire lifespan. Can that be correct? My PNP program was 700 hours for birth to 18 (including an OB/sexual health rotation for adolescents). Seems as if the FNP would be at least that ma...