understanding Insulin and Heparin Dosing pls help

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Calling all nurses..

I'm new to nursing and I know this may seem a stupid question but I just wanted to know.. I will be starting my clinicals soon so....

What I understand about Insulin is they are ordered by units. For pens, easy just dial to the desired order, however for the other insulins I've read to just also draw up the desired unit, for example (just making this number up) 30 units of long acting, then you just draw 30 units using an insulin syringe and give to patient. In the other problem I've encountered they're using D/H formula (Eg. 20 units of Regular Insulin. You are using U-100 insulin. how many ml do you give: answer 0.2ml) I was thinking of just drawing 20 units in a bottle. How do I know if I should just draw up the ordered unit or use the D/H formula. Pls explain... I don't want to give the wrong dose. I'm so anxious.

For Heparin, for example, doctor ordered 5,000 units SC. I have 3 choices (5,000/0.2ml) (5,000/1ml) (5,000/2ml) which do I choose? Does it matter?

Pls help I'm so nervous.

Being overdosed on insulin can have very serious or even fatal consequences for a patient, especially if the patient has other significant medical problems, if the error is not caught and remedied very quickly. I have no problem with having been taught to double check insulin with another nurse if it helps me to prevent an error in administration, thereby sparing a patient from the burden of receiving additional treatment that would not ordinarily have been necessary, or if it helps prevent serious patient injury or death.

Certainly, though any inadvertent hypoglycemia I've ever seen in a hospital setting has been recognized and addressed promptly, and it's an easy fix.

But the effects of ODing on digoxin or gentamycin may be more subtle, and are not reversible.

Specializes in ED; Med Surg.
No, it isn't gospel. We are allowed to give insulin both in drips and subc. without a cosigner where I work. There are meds that require a co-signers, but insulin isn't one of them.

Gospel doesn't always equal protocol. I always have someone check my insulin.

Oh one more thing for a heparin dose of 5,000 units/0.2 ml in an ampule do I have to measure if it's 0.2 or do I just give the whole ampule? I know there are different doses per ampule e.g 5,000/1ml, 5,000/2ml, so do I have to measure those mls? Cause I've seen them just give the whole ampule.

Oh one more thing for a heparin dose of 5,000 units/0.2 ml in an ampule do I have to measure if it's 0.2 or do I just give the whole ampule? I know there are different doses per ampule e.g 5,000/1ml, 5,000/2ml, so do I have to measure those mls? Cause I've seen them just give the whole ampule.

YOU ALWAYS MEASURE. Most ampules and vials of liquids have extra in them for spillage and that little squirt when you're clearing the air out of the syringe. NEVER, NEVER forget to measure accurately. If the amp says, "5000 units/0.2ml," it's not saying, "5000 units/0.3 or 0.4 or whatever we put in here ml." Measure that 0.2ml or else.

Thanks Gnt tea, the problem in the facility is that they're using insulin syringes for heparin so I'm not sure how to measure it. Pls advise on how to measure it.

Thanks Gnt tea, the problem in the facility is that they're using insulin syringes for heparin so I'm not sure how to measure it. Pls advise on how to measure it.

Not all 1cc syringes are insulin syringes. If they aren't marked in UNITS (not cc) (which refers to insulin units, not heparin units) and have regular needles and not those integral skinny little subq needles, you use them as 1cc syringes, because that's what they are. CHECK.

If they really only give you insulin syringes, this is a major error risk, and you should take it up with your RM department. Meanwhile, though, insulin syringes are still 1cc syringes. So you ought to be able to figure out how to draw up 0.2cc in one, nu? What confuses you?

@ Gnt Tea...I got it for 0.2 I draw up until 20 units. I agree with you of the risk of error, but I think that they are using this kind of syringe for the comfort of the patient because the needle is so fine.

@ Gnt Tea...I got it for 0.2 I draw up until 20 units. I agree with you of the risk of error, but I think that they are using this kind of syringe for the comfort of the patient because the needle is so fine.

Th answer is 0.2cc, which for a U100 syringe looks like 20 units. Just remember that insulin units does not equate to heparin (or anything else) units.

It's still an error risk.

Be careful they don't substitute U80 syringes on you someday.

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