Interactions with other patient drugs, OTC orherbal medicines
(ask patient specifically)
may block some of the signs andsymptoms of hypoglycemia and delay recovery fromhypoglycemia (Coreg). Chronic use of alcohol mayincrease insulin requirements. Acute use of alcoholand beta blockers (nonselective) may decreaseinsulin requirements. Oral hypoglycemic agents(Glucophage) may ↓ insulin requirements.
Lab value alterations caused by medicine
May cause ↓ serum inorganic phosphate, magnesium, and potassium levels.
Be sure to teach the patient the following about thismedication
Instruct patient on proper technique for administration.Include type of insulin, equipment (syringe, cartridge pens,external pumps, alcohol swabs), storage, and place todiscard syringes. Discuss the importance of not changing brands of insulin or syringes, selection and rotation of injection sites, and compliance with therapeutic regimen.Explain to patient that this medication controlshyperglycemia but does not cure diabetes. Therapy is longterm. Emphasize the importance of compliance withnutritional guidelines and regular exercise as directed byhealth care professional. Advise patient to notify healthcare professional of medication regimen prior to treatmentor 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 notcontrolled. Instruct patient on signs and symptoms of hypoglycemia and hyperglycemia and what to do if theyoccur. Patients with diabetes mellitus should carry a sourceof sugar (candy, sugar packets) and identificationdescribing their disease and treatment regimen at all times.Emphasize the importance of regular follow-up, especiallyduring first few weeks of therapy.
Nursing Process- Assessment
Blood sugar monitoring. Assess for signsand symptoms of hypoglycemia (anxiety;chills; cold sweats; confusion; cool, paleskin; 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 bodyweight periodically. Changes in weightmay necessitate changes in insulin dose.
Why would you hold or not give thismed?
Hypoglycemia, blood sugar withinnormal range.
Check after giving
Control of blood glucoselevels without theappearance of hypoglycemicor hyperglycemic episodes.