Humulin R, Novolin R

NURS 1556 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Trade Name regular insulin Humulin R, Novolin R Peak Onset 2-4 hr 30-60 min

Classification Dose Route Time/frequency Anti diabetics, Sliding Scale SQ Fingerstick blood sugar hormones checks q AC & HS Duration For IV meds, compatibility with IV drips and /or 5-7 hr solutions

Mechanism of action and indications (Why med ordered) Lower blood glucose by increasing transport into cells and promoting the conversion of glucose to glycogen. Promote the conversion of amino acids to proteins in muscle and stimulate triglyceride formation. Inhibit the release of free fatty acids. For Diabetes

Nursing Implications (what to focus on) Contraindications/warnings/interactions - Allergy or hypersensitivity to a particular type of insulin, preservatives, or other additives, stress, infection (temporarily increase insulin requirements). Common side effects - Lipodystrophy, HYPOGLYCEMIA, ANAPHYLAXIS.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) – Corticosteroids such as Prednisone.

Lab value alterations caused by medicine - May cause decrease serum inorganic phosphate, magnesium, and potassium levels. Be sure to teach the patient the following about this medication - Instruct patient on proper technique for administration. Include type of insulin, equipment (syringe, cartridge pens, external pumps, alcohol swabs), storage, and place to discard syringes. Discuss the importance of not changing brands of insulin or syringes, selection and rotation of injection sites, and compliance with therapeutic regimen. Therapy is long term. Emphasize the importance of compliance with nutritional guidelines and regular exercise as directed by health care professional. Advise patient to notify health care professional of medication regimen prior to treatment or surgery. Advise patient to notify health care professional if nausea, vomiting, or fever develops, if unable to eat regular diet, or if blood glucose levels are not controlled. Instruct patient on signs and symptoms of hypoglycemia and hyperglycemia and what to do if they occur. Patients with diabetes mellitus should carry a source of sugar (candy, sugar packets) and identification describing their disease and treatment regimen at all times. Emphasize the importance of regular follow-up, especially during first few weeks of therapy.

Nursing Process- Assessment (Preadministration assessment) - Blood sugar monitoring. Assess for signs and symptoms of hypoglycemia (anxiety; chills; cold sweats; confusion; cool, pale skin; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nausea; nervousness; rapid pulse; shakiness; unusual tiredness or weakness) and hyperglycemia (drowsiness; flushed, dry skin; fruit-like breath odor; frequent urination; loss of appetite; tiredness; unusual thirst) periodically during therapy. Monitor body weight periodically. Changes in weight may necessitate changes in insulin dose.

Assessment Why would you hold or not give this med? - Hypoglycemia, blood sugar within normal range. Under 150 or if over 400 call Dr.

Sliding Scale: 151 – 200 = 2 units 201 – 250 = 4 units 251 – 300 = 6 units 301 – 350 = 8 units 351 – 400 = 10 units Call MD > 400

Evaluation Check after giving - Control of blood glucose levels without the appearance of hypoglycemic or hyperglycemic episodes.