Pt safety concern: Lispro vs Regular

applewhitern, BSN, RN · Aug 21, 2011

I doubt there would be a problem. Lispro peaks in 30-90 minutes, and has a duration of about 5 hours. It just works a little faster than regular, but if you are worried, just re-check the sugar. Six units is not too much for a blood sugar of 212, esp. with continuous feeds.

Retrox24 · Aug 21, 2011

I doubt there would be a problem. Lispro peaks in 30-90 minutes, and has a duration of about 5 hours. It just works a little faster than regular, but if you are worried, just re-check the sugar. Six units is not too much for a blood sugar of 212, esp. with continuous feeds.

Thank you so much for that info. :lol2:I think i just needed some reassurance that the patient wont get hypoglycemic, and youre definitely right. It makes sense. My brain just did a double take because i realized what had happened when i was already heading home..and to think i had another nurse double check it. :eek:I dont remember what went wrong (perhaps giving insulin to 5 patients including lantus did it)... And i now have greater appreciation for my own unit after floating to snf. :oIm not used to 9 patients... Definitely dangerous and at high risk for med errors.. I dont know the regular nurses there do it.. :nurse: Thanks again!

xtxrn, ASN, RN · Aug 21, 2011

In a pinch, I can interchange them (on myself :)), with no problems. I use NovoLog ac, and know that the only thing to really look out for is the onset- but w/continuous feeds, that shouldn't be an issue :)

Retrox24 · Aug 21, 2011

Thanks so much xtxrn, i really appreciate that info. Im actually glad the pt is on continuous tf. It makes a big difference to give insulin to a pt on tf vs a patient who is not eating or npo. But ive learned my lesson to take my time with blood sugars, because safety matters! But seriously, im a paranoid worrywart..lol thanks for the advice!

CoffeeRTC, BSN, RN · Aug 21, 2011

That isn't that much insulin for a tube feeder rtc.

I work LTC that is part sub acute (of course they don't call it that) but mostly rehab. Out of 22 pts, I can have up to 10 blood sugars to check. Most are qid with coverage and include lantus too. PIA. I guess you just get used to it. I would feel weird asking others to check my insulin and got some strange looks when I tried it when I was new. You do get used to be cautious and giving so much inulin and doing all the accu checks.

Retrox24 · Aug 21, 2011

that isn't that much insulin for a tube feeder rtc.
i work ltc that is part sub acute (of course they don't call it that) but mostly rehab. out of 22 pts, i can have up to 10 blood sugars to check. most are qid with coverage and include lantus too. pia. i guess you just get used to it. i would feel weird asking others to check my insulin and got some strange looks when i tried it when i was new. you do get used to be cautious and giving so much inulin and doing all the accu checks.

thanks for that feedback, michelle. im always impressed at how u guys do it ( handling > than 10 pts) since i have no experience with snf. i work at a hospital and often get floated to other units, including snf. ive floated to that unit a few times and they always call another rns attention for the insulin they are giving.. but after reading some posts from this website, it really defeats the purpose to do it when they dont show the order, and there are too many patients to really take the time to meticulously check the whole 5 pt rights. thanks again for your perspective :up:

Schatzi RN CEN · Aug 22, 2011

Although no harm was done, you need to be sure to report the error. This will ensure that other nurses can use your experience to avoid making the same error.

Retrox24 · Aug 22, 2011

Definitely, thanks Schatzi! :)

#1ME · Aug 24, 2011

No biggie OP. Now, if you gave 30 units of Lispro, instead of 30 units of Lantus or Levamir, you and the pt would be in trouble