Insulin sliding-scale

Administer the dose according to the regular insulin sliding scale. 

Regular insulin sliding scale to an elderly client diagnosed with Type 1 diabetes mellitus. 

The nurse administers supplemental insulin based on blood glucose readings and the amount of insulin prescribed by the health care provider in the sliding scale. The nurse must notify the health care provider if the blood glucose level is greater than 400 mg dL. 

Example of Insulin Administration Using a Sliding Scale... 

Sliding scale insulin Allopurinol 1 00 mg orally daily Ranitidine 150 mg orally every 12 hours Atenolol 50 mg orally daily Enalapril 2.5 mg orally daily... 

Insulin lispro subcutaneously per sliding scale with meals... 

Thereafter, the preceding parameters and other nutritional parameters should be monitored routinely or as indicated (Table 97-8). Random capillary blood glucose concentrations also should be monitored every 6 to 8 hours when initiating PN, and regular insulin should be administered to control glucose as needed (either by intermittent administration per sliding scale or as a continuous infusion). 

A sliding scale insulin infusion of Actrapid 50 units made up to 50 mL with sodium chloride 0.9% was initiated and titrated against blood glucose. 

The hyperglycaemia will respond to the insulin and glucose used to treat the hyperkalaemia. The patient is unstable, and it is evident his usual oral diabetic medication is insufficient to control his diabetes at present. Therefore he should be put on a sliding scale insulin infusion until such time that his gly-caemic control has improved and he is considered stable enough to re-introduce the oral gliclazide therapy. Blood glucose levels should be monitored very closely. 

Preprinted order set design Hypokalemia Sliding scale insulin Continuous renal replacement therapy... 

Soluble insulin, preferably from the same species the patient has been using (never a sustained-release form), should be given by continuous i.v. infusion of a 1 unit/ml solution of insulin in isotonic sodium chloride. It is best to use a pump, which allows independent control of insulin and electrolyte administration more readily than an i.v. drip. If a pump is not available, the insulin should be added in a concentration of 1 unit/ml to 50-100 ml of sodium chloride in a burette. The infusion rate is determined by a sliding scale, as illustrated in Table 35.2. The rate is adjusted hourly using the same scale. If an i.v. drip is used instead of a pump the concentration should be lower (40 units/I). Stringent precautions against septicaemia are necessary in these patients. Continuous infusion i.m. (not s.c.) can also be equally effective, provided the patient is not in shock and provided there is not an important degree of peripheral vascular disease. 

TABLE 3S.2 Sliding scale of insulin doses according to blood glucose concentrations in ketoacidosis (see text) ... 

Day of operation omit morning s.c. dose set up i.v. infusion glucose 5-10% + KCl 20 mmol/I, infuse at 100 ml/h insulin 20 units may be added to 1 litre of infusate or infused by pump at a basal rate of 2-3 units/h and adjusted according to a sliding scale. 

Serum glucose level is usually taken before administering insulin. Healthcare providers prescribe insulin on a sliding scale based on the level of serum glucose. This assures that the correct dose of insuhn is administered. If too much insuhn is administered, the patient experiences hypoglycemic reaction (Table 21.3). 

Split mix Intermediate-acting insulin (lAI) -i-short-acting insulin (SAI) (vial) (2 1 ratio AM, 1 1 ratio PM or SAI sliding scaled) ar premix 70/30 75/25 or 50/50 (penAfial)... 

Sawin CT. Action without benefit. The sliding scale of insulin use. Arch Intern Med 1997 157 489. 

The client with Type 2 diabetes is admitted into the medical department with a wound on the left leg that will not heal. The HCP prescribes sliding-scale insulin. The client tells the nurse, I don t want to have to take shots. I take pills at home. Which statement would be the nurse s best response ... 

Humulin R insulin is administered by sliding scale to decrease blood glucose levels. CHents with pancreatitis should be monitored for the development of diabetes mellitus. Polydipsia and polyuria are classic signs of diabetes mellitus. 

The sliding-scale regular insulin to a client with Tjqre 2 diabetes. 

Humulin N insulin is not administered by sliding scale, and for acidosis the treatment is the more rapid-acting Humulin R insulin. 

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