Questions your instructor will ask about insulin:
What is the morning blood sugar? It makes a difference if the blood sugar is 34 or 334 as to how you will proceed.
Is the patient nauseated, vomiting or NPO? If so, the patient will not be eating and if you give them insulin they will become hypoglycemic. If it is sliding scale usually it will be given. If they are NPO for surgery sometimes they receive half their routine dose. However, always report any insulin given to the OR nurse so they are aware.
What is the onset, peak, and duration of this insulin?Students really dread this question but its important information to know. The onset is important because you need to give it in an appropriate time frame in relation to when the patient eats. The peak lets you know when the greatest chance of hypoglycemia is, and the duration is when is the coverage going to run out. Remember is you are giving premixed insulin or you are mixing insulins the effect will be the patient will have the onset, peak, and duration of both types of insulin in the mixture. Make a chart on an index card to keep in your pocket.
The client's blood sugar is 100 should you give the insulin? If it is the patient's routine dose, most likely yes. Wait until the patient has their meal tray if it has rapid or short acting insulin mixed in. The whole idea of scheduled insulin is to maintain the blood sugar in a normal range.
The client is on 30 units of NPH in the am and the blood sugar is 240, should you give the sliding scale as well? Yes, the idea is that the routine insulin dosages will maintain the blood sugar within normal limits, while the sliding scale is regular insulin designed to cover the elevated blood sugar now.