Medical Managemen t

Isophane insulin (humulin N)

Date ordered, Date Performed, Date changed Date Ordered: Jan. 05,2014 Date performed: Jan 05, 2014 to Jan. 06,2014

Route of administration dosage and frequency of administration 65 'u' SC in AM 40 'u' SC in PM

General Action Functional classification Mechanism Action General Action:

Indication Initial Reaction Purpose of

Clients response to medication and actual side effect

Stimulates peripheral glucose uptake, inhibits hepatic glucose production, inhibits lipolysis and proteolysis, regulating glucose metabolism

Indication: The patient was prescribed of this medication in order to control her hyperglycemia

The patient's blood glucose level gradually decreased from 403 on 1/5/14 to 100 on 1/6/14

Classification: Antidiabetic agent Mechanism Action: of

Increase glucose transport across muscle and fat cell membranes to reduce blood glucose level. Promotes conversion of glucose to its storage form, glycogen; triggers amino acid uptake and conversion to protein in muscle cells and inhibits protein degradation; stimulates triglyceride formation and inhibits release of free fatty acids from adipose tissue; and

stimulates lipoprotein lipase activity, which converts circulating lipoproteins to fatty acids.

Medical Managemen t

Insulin Recombinant (humulin R)

Date ordered, Date Performed, Date changed Date Ordered: Jan. 05,2014 Date performed: Jan 05, 2014 to Jan. 06,2014

Route of administration dosage and frequency of administration 40 'u' SC TID

General Action Functional classification Mechanism Action General Action:

Indication Initial Reaction Purpose of

Clients response to medication and actual side effect

Stimulates peripheral glucose uptake, inhibits hepatic glucose production, inhibits lipolysis and proteolysis, regulating glucose metabolism

Indication: The patient was prescribed of this medication in order to control her hyperglycemia

The patient's blood glucose level gradually decreased from 403 on 1/5/14 to 100 on 1/6/14

Classification: Antidiabetic agent Mechanism Action: of

Administered insulin, including Humulin R U-100, substitutes for inadequate endogenous

insulin secretion and partially corrects the disordered metabolism and inappropriate hyperglycemia of diabetes mellitus, which are caused by either a deficiency or a reduction in the biologic effectiveness of insulin. When administered in appropriate doses at prescribed intervals to patients with diabetes mellitus, Humulin R U-100 restores their ability to metabolize carbohydrates, proteins and fats.

NURSING RESPONSIBILITIES BEFORE

Ensure uniform dispersion of insulin suspensions by rolling the vial gently between hands; avoid vigorous shaking. Give maintenance doses subcutaneously, rotating injection sites regularly to decrease incidence of lipodystrophy; give regular insulin IV or IM in severe ketoacidosis or diabetic coma. 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. Use caution when mixing two types of insulin; always draw the regular insulin into the syringe first; if mixing with insulin lispro, draw the lispro first; use mixtures of regular and NPH or regular and Lente insulins within 5 15 min of combining them; Lantus insulin (insulin glargine) cannot be mixed in solution with any other drug, including other insulins.

DURING Know that usual administration route is SC. for proper SC administration, remember to pinch a fold of skin with the fingers at least
3 inches apart, and insert at a 45- to 90-degree angle, depending on the type of syringe.

AFTER

Press but do not rub site after injection. Rotate injection sites and chart to avoid overuse of one area. Know that diabetic patients may achieve better control if injection site is rotated within same anatomic region. Store insulin in cool area. Refrigeration is desirable but not essential, except with regular insulin concentrated.