Diabetes Scenaio
Diabetes Scenario
Failing to double check the name of a nursing home resident, a student nurse accidentally gives 13 units of 70/30 insulin to a patient who also received glipizide this morning. * What should the student nurse do when she realizes the error? * Report the error to her preceptor Nurse, along with the Nursing Supervisor.
* At what point would the insulin peak and when should blood sugars be checked? * 70/30 insulin has a peak of 2-12 hours. * Blood sugars should be checked immediately, repeated hourly until the patient’s blood sugar has stabilized. * If the patient is hypoglycemic provide interventions based on severity to reverse the hypoglycemia.
* What does glipizide to and at what point will it take full effect? * Glipizide is an oral diabetes medication that helps the pancreas produce insulin. It takes 15-30 minutes to begin taking effect, with a peak of 1-2 hours. * What should be done to troubleshoot this scenario? * Find out what time the patient took his/her glipizide. * Find out the last time
* Is there an antidote to insulin? * Yes, glucagon.
At the end of her night shift a nurse gives Lantus 3 units and Log insulin 23 units via flexpen to a patient who was supposed to get Lantus 23 units & Log insulin 3 units of just before breakfast. * What are the implications of this mistake? * The patient has received nearly 8 times the prescribed dose of rapid acting insulin and 1/8th the dose of long acting insulin that is needed. The patient will likely begin experiencing symptoms of hypoglycemia rapidly as Log insulin has an onset of 15 mins. The patient will also not have enough long acting insulin to control the patient’s blood sugar throughout the remainder of the day.
* What should be done when the error is discovered? * The nurse should report the medication error
Failing to double check the name of a nursing home resident, a student nurse accidentally gives 13 units of 70/30 insulin to a patient who also received glipizide this morning. * What should the student nurse do when she realizes the error? * Report the error to her preceptor Nurse, along with the Nursing Supervisor.
* At what point would the insulin peak and when should blood sugars be checked? * 70/30 insulin has a peak of 2-12 hours. * Blood sugars should be checked immediately, repeated hourly until the patient’s blood sugar has stabilized. * If the patient is hypoglycemic provide interventions based on severity to reverse the hypoglycemia.
* What does glipizide to and at what point will it take full effect? * Glipizide is an oral diabetes medication that helps the pancreas produce insulin. It takes 15-30 minutes to begin taking effect, with a peak of 1-2 hours. * What should be done to troubleshoot this scenario? * Find out what time the patient took his/her glipizide. * Find out the last time
* Is there an antidote to insulin? * Yes, glucagon.
At the end of her night shift a nurse gives Lantus 3 units and Log insulin 23 units via flexpen to a patient who was supposed to get Lantus 23 units & Log insulin 3 units of just before breakfast. * What are the implications of this mistake? * The patient has received nearly 8 times the prescribed dose of rapid acting insulin and 1/8th the dose of long acting insulin that is needed. The patient will likely begin experiencing symptoms of hypoglycemia rapidly as Log insulin has an onset of 15 mins. The patient will also not have enough long acting insulin to control the patient’s blood sugar throughout the remainder of the day.
* What should be done when the error is discovered? * The nurse should report the medication error
References: Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: Patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.