Your 18-year-old patient, Ms. Dex, is a Type 1 diabetic, who arrived in the emergency department in diabetic ketoacidosis. Her blood glucose is over 1050 mg/dL. She received a bolus of isotonic fluid.
The physician’s order reads:
Give regular insulin by continuous infusion at the rate of 0.2 units/kg/hour. Leslie weighs 132 lbs.
The medication is available in a solution of 200 units of regular insulin in 100 mL normal saline.
8) How many milliliters (mLs) of the insulin solution will Leslie receive over one hour?
9) The physician calls to inquire about the patient’s condition 1 hour and 30 minutes after the infusion starts. She asks how many units of the insulin have been delivered via the infusion. Calculate how many units of insulin Leslie will receive over 1 hour and 30 minutes (round to the nearest decimal)?
Ms. Dex’s blood glucose level has stabilized. There is a new order for a subcutaneous insulin injection, which reads:
“Check blood glucose levels before meals and at bedtime. For every 4 mg/dl over 140mg/dl, give one unit of Regular Humulin insulin, subcutaneously.”
The nurse knows that the smallest increment that can be drawn up in an insulin syringe is one unit (no partial units).
10) At 5:00 pm, Ms. Dex’s blood glucose level at was measured at 172 mg per deciliter (mg/dl). How many units of insulin will the nurse administer via subcutaneous injection to the patient?
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