Type 1 diabetes

[cjl_RN]

You think you know diabetes until you take care of a kiddo with type 1! So I had a student elementary age who @ lunch was 255. I corrected him and gave him insulin for his carbs at 11:45. He then came to me at 12:57 w/ a snack in class a 19g carbs of Kool aid. He told me he doesn't check his sugar since it's been close and he doesn't feel low. But he will need a carb bolus. I covered him with a 1/2 unit. Rechecked his blood sugar at end of school day at 4:05 and it was 192. Parent called me and was upset said I should have never given him the 1/2 unit w/o getting a fingerstick. I recently took a class where they said it's unesscary to recheck blood sugar unless child is having s/sx hypoglycemia bc they have to be covered for the carbs. I feel like a horrible nurse now. Next time if I'm ever put in the situation I will attempt to call the parent. Do you Nurse's always check before carb bolus only not correction? Another nurse I shawdow didn't not check before carb bolus if it were close since last blood sugar. Constructive criticism welcome. I am very new at this.

[Rubor]

I always check before giving insulin. Do you have a care plan for the student? I will tell ya each student is different so you think you know diabetes but then you have 15 diabetics (that's how many I have). Each family is different and even some of the "standing" orders are written differently.

[ruby_jane, BSN, RN]

But in general do you normal give insulin for snack w/o blood sugar?

If the order requires it, yes. If not, no.

Look at it this way: if you've given insulin two hours ago for blood sugar, you're not going to give more insulin for that same blood sugar. THat insulin you gave is still working.

If you do correct again, you're likely to tip that student into hypoglycemia. So checking before a snack gives you a number but if you're not in the parameters to correct, what do you do with that number?

[cjl_RN, BSN]

Do you work at high school?

[cjl_RN, BSN]

Well in this sense I'm not worried about a correction bc I had already corrected. I need to give insulin for the carbs he consumes, which we use the carb ratio. Not the correction factor or target. What will the blood sugar number give me in regards to giving insulin for carbs/snacks for my insulin. Other than checking to make sure he doesn't realize he is low. Which he exhibited no s/sx.