Classification of the Drug: Humulin R

Common Indications of the Drug:

Common Brand Names:

Assessment Possible Nursing Diagnoses

Assessment Prior to administration: •Risk for Injury (hypoglycemia), related to
•Assess any patient allergies. Older forms of
adverse effects of drug therapy
insulin are made from beef and pork and may
cause allergic reactions in sensitive patients.
•Deficient Knowledge, related to the need for
•Assess vital signs. self-injection

•Assess blood glucose level. •Risk for Imbalanced Nutrition, related to

adverse effects of drug therapy
•Assess appetite and the presence of any
symptoms that indicate the patient will not be
able to consume or retain the next meal •Deficient Knowledge, related to the
. management of the disease process
•Assess subcutaneous areas for lipodystrophies
and other areas that are possible insulin
injection sites.

•Assess the patient's knowledge of insulin and

insulin administration.

•Assess potassium level

Planning: Patient Outcomes

The patient will:

•Demonstrate knowledge of symptoms of complications of drug therapy including irritability,

dizziness, diaphoresis, hunger, behavior changes, and changes in the level of consciousness

Implementation
Interventions with Rationales
 Ensure uniform dispersion of insulin ● Teach the patient how to administer insulin
suspensions by rolling the vial gently
between hands; avoid vigorous shaking.
 Give maintenance doses subcutaneously,
rotating injection sites regularly to
decrease the incidence of lipodystrophy;
give regular insulin IV or IM in severe
ketoacidosis or diabetic coma.
 Obtain baseline and periodic PFTs for
patients using inhaled insulin; carefully
monitor glucose levels when converting
from subcutaneous to inhaled insulin
 Monitor patients receiving insulin IV
carefully; plastic IV infusion sets
have been reported to remove 20%–
80% of the insulin; dosage delivered
to the patient will vary.
 Do not give insulin injection concentrated
IV; severe anaphylactic reactions can
occur.
 Monitor urine or serum glucose levels
frequently to determine the effectiveness
of the drug and dosage. Patients can learn
to adjust insulin dosage on a sliding scale
based on test results.
Patient Education/Discharge Planning
subcutaneously as appropriate
● Advise patient to draw up regular in syringes to
syringe first when mixing two types of insulin.
Caution him not to change the order of mixing
insulins.
● Instruct patient to rotate subcutaneous injection
sites and keep a record of sites used, to prevent
fatty tissue break do each patient how to
recognize and report signs and symptoms of
hypoglycemia and hyperglycemia. Advise him to
carry a glucose source at all times.
● Instruct patient to store insulin in the
refrigerator (not the freezer).
● Teach the patient how to monitor and record
blood levels and, if indicated, urine glucose and
ketone levels.
● Tell the patient at dietary changes, activity, and
stress can alter blood glucose level and insulin
requirements.
● Instruct patient to wear medical identification
stating that he is diabetic and takes insulin.
● Advise patient to have regular medical, vision,
and dental exams.
● As appropriate, review all other significant and
life-threatening adverse reactions and
  Monitor insulin needs during times of interactions, especially those related to the drugs,
trauma or severe stress; dosage tests, herbs,
adjustments may be needed.

Evaluation of Outcome Criteria (Met, Partially met, Not met)

Goals are met.
 Patient responds well to therapy (stabilization of blood glucose levels).
 Patient understanding of drug therapy by asking the patient to name the drug, its indication,
and adverse effects to watch for.

Reference:

NPF Drug Study No. 1