APPENDIX I MEDICATION ADMINISTRATION Student Name: __________Erin Nowlin_______________ Date of Care: _____04/21/2011__________ Client Allergies: _NKDA DRUG Generic: Insulin regular Brand: Humulin R Onset: immediate Peak: unknown Duration: unknown O2 Sat DOSAGE ROUTE & FREQUENCY Client: Sliding scale: give insulin subcutaneously every 6 hours Glu Insulin 130-150 2 units 151-200 4 units 201-250 6 units 251-300 8 units 301-350 10 units 351-400 12 units >401 call MD Usual: Dosage varies among patients and must be determined by prescriber. Client Initial: ___ KWE________ FLUID TYPE Primary: CLASSIFI CATION Pharmacologic Classification: PURPOSE OF DRUG (Indication) Specific to the Client: MAJOR NURSING IMPLICATIONS MATH CALCULATIONS Adverse Reactions (2): gtt/min: Metabolic: hypoglycemia Skin: lipodystrophy Pancreatic hormone hyperglycemia _ Isotonic _ Hypotonic _ Hypertonic Secondary: Action (patho): Increases glucose transport across muscle and far cell membranes to reduce glucose level. Helps convert glucose to glycogen; triggers amino acid uptake and conversion to protein in muscle cells; stimulates triglyceride formation and inhibits release of free fatty acids from adipose tissue; and Usual: hyperglycemia V/S to assess before admin. Assess all VS Labs to assess before admin. FSBG Interactions: (2) Corticosteroids: May decrease the mL/hr: glucose-lowering effect of insulin and cause hyperglycemia. Salicylates: May enhance the glucose-lowering effect of insulin and may Push rate: potentiate hypoglycemia. Effects on Labs: (2) May decrease glucose, magnesium, and potassium levels Dilution: Nursing Considerations (2): Some patients may develop insulin resistance (Must Show all math) stimulated lipoprotein lipase activity, which converts circulating lipoproteins to fatty acids. and need large insulin doses to control symptoms of diabetes. Adjust dose regularly, according to patient's glucose measurements. Monitor glucose level regularly. Client Teaching(1): Advise patient of the warning signs of low glucose level (shaking, sweating, moodiness, irritability, confusion, or agitation). Tell patient to carry sugar (candy, sugar packets) to counteract low glucose level. Antidote: None listed Black Box Warning: None listed Remember Pain is the 5th V/S References: Kluwer, W. (2011) Nursing 2011 drug handbook (31st ed.). Ambler,Pennsylvania:Lippincott Williams&Wilkins