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NURS 1556 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency


regular insulin Humulin R, Anti diabetics, Sliding Scale SQ Fingerstick blood sugar
Novolin R hormones checks q AC & HS
Peak Onset Duration For IV meds, compatibility with IV drips and /or
2-4 hr 30-60 min 5-7 hr solutions

Mechanism of action and indications (Why med ordered) Nursing Implications (what to focus on)
Lower blood glucose by increasing transport into cells Contraindications/warnings/interactions - Allergy or
and promoting the conversion of glucose to glycogen. hypersensitivity to a particular type of insulin,
Promote the conversion of amino acids to proteins in preservatives, or other additives, stress, infection
muscle and stimulate triglyceride formation. Inhibit the (temporarily increase insulin requirements).
release of free fatty acids. For Diabetes Common side effects - Lipodystrophy,
HYPOGLYCEMIA, ANAPHYLAXIS.

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine - May cause
medicines (ask patient specifically) – Corticosteroids decrease serum inorganic phosphate, magnesium, and
such as Prednisone. 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 (Pre- Assessment Evaluation Check after
administration assessment) - Blood sugar Why would you hold or not give this giving - Control of blood
monitoring. Assess for signs and symptoms med? - Hypoglycemia, blood sugar glucose levels without the
of hypoglycemia (anxiety; chills; cold sweats; within normal range. Under 150 or if appearance of
confusion; cool, pale skin; difficulty in over 400 call Dr. hypoglycemic or
concentration; drowsiness; excessive hunger; hyperglycemic episodes.
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.

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