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Novolin R SQ (Regular Insulin)

Novolin R SQ (Regular Insulin)

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Published by: E on Sep 24, 2008
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05/27/2013

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NURS 1566 Clinical Form 3: Clinical Medications Worksheets
(You will need to make additional copies of these forms)
Generic Name
regular insulin
Trade Name
Humulin R, Novolin R 
Classification
antidiabetics
Dose
(BS -100)/40 =units of insulin
Route
SQ
Time/frequency
Fingerstick blood sugar checks q AC & HS
Peak 
2-4 hr 
Onset
30-60 min
Duration
5-7 hr 
Normal dosage range
0.5-1 unit/kg/day
Why is your patient getting this medication
Diabetes mellitus
For IV meds, compatibility with IV drips and/orsolutions
Medication errors involving insulins have resulted inserious patient harm and death. Clarify all ambiguousorders and do not accept orders using the abbreviation "u"for units, which can be misread as a zero or the numeral 4and has resulted in tenfold overdoses. Insulins are availablein different types and strengths and from different species.Check type, species source, dose, and expiration date withanother licensed nurse. Do not interchange insulins withoutconsulting physician or other health care professional. Donot confuse regular 
concentrated (U-500)
insulin withregular insulin. Use
only
insulin syringes to draw up dose.The unit markings on the insulin syringe must match theinsulin's units/ml. Special syringes for doses <50 units areavailable. Prior to withdrawing dose, rotate vial between palms to ensure uniform solution; do not shake. Whenmixing insulins, draw regular insulin or insulin lispro intosyringe first to avoid contamination of regular insulin vial.Insulin should be stored in a cool place but does not needto be refrigerated. If unable to refrigerate, the 10- ml vialcan be kept in a cool place unrefrigerated for up to 28 days,and the 5-ml vial, up to 14 days.
Mechanism of action and indications
(Why med ordered)
Lower blood glucose by increasing transport intocells and promoting the conversion of glucose toglycogen. Promote the conversion of amino acids to proteins in muscle and stimulate triglycerideformation. Inhibit the release of free fatty acids.
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.
 
Interactions with other patient drugs, OTC orherbal medicines
(ask patient specifically)
Beta blockers
 
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
(Pre-administration 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.
Assessment
Why would you hold or not give thismed?
Hypoglycemia, blood sugar withinnormal range.
Evaluation
Check after giving 
Control of blood glucoselevels without theappearance of hypoglycemicor hyperglycemic episodes.

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