Pharmacology Diabetes meds #5

Question

Which action by a graduate nurse would warrant the charge nurse to intervene?

Answers

  1. Checking a bedside glucose level prior to administration of sliding scale insulin
    • Rationale:

      This answer is not correct because checking a bedside glucose level prior to administration of sliding scale insulin is an action the charge nurse would not correct and intervene during. Mixing glargine insulin with any other insulin is not correct and the other nurse should intervene immediately.

  2. Pulling up glargine insulin into the insulin syringe first, then regular insulin
    • Rationale:

      This answer is correct because pulling up glargine insulin into the insulin syringe first, then regular insulin is an incorrect and unsafe action. The charge nurse would intervene to help prevent negative consequences, including long lasting decline in blood glucose. Glargine insulin should be pulled up in a separate insulin syringe and separate injections given, if other insulin is prescribed.

  3. Giving regular insulin intravenously to a diabetic patient in metabolic acidosis
    • Rationale:

      This answer is not correct because giving regular insulin intravenously to a diabetic patient in metabolic acidosis is a safe practice. Regular insulin may be prescribed and administered intravenously or subcutaneously.

  4. Administering aspart insulin immediately before the patient eat supper
    • Rationale:

      This answer is not correct because administering aspart insulin immediately before the patient eats supper is a correct and safe action. This insulin is normally given 15-20 minutes before the patient eats because it acts so quickly.

Overview

Glargine insulin is a long-acting insulin, which should never be mixed with any other insulin. A separate injection is required for glargine insulin, when other insulin is prescribed.

Explanation

Learning Outcomes

Glargine is used to provide long-acting insulin coverage in patients who are diabetics, especially type 1 diabetics. In type 1 diabetes mellitus, the pancreas does not produce its own insulin. In this patient, when the blood glucose naturally increases from food intake, stress, or medications, this person’s pancreas cannot respond with appropriate levels of insulin to maintain normal blood glucose levels. Insulin glargine and faster acting insulins, such as regular insulin, is utilized throughout the day to maintain adequate blood glucose control. Due to the potential of mixing glargine with faster acting insulin, evidenced based nursing procedure is to never mix glargine with any other insulin. A separate injection is required if other insulin is being administered at the same time.

Test Taking Tip

If a NCLEX-style question is asking when an experienced nurse should “intervene”, this means the test-taker should choose something the other nurse is doing incorrectly or unsafely.

Video Rationale