INSULIN (REGULAR)

(in’su-lin)
Humulin R, Novolin R, Regular Insulin, Pork Regular Iletin II, Regular Purified Pork Insulin, Velosulin, Velosulin BR, Velosulin Human
Classifications:
hormone and synthetic substitute; antidiabetic agent; insulin
Pregnancy Category: B

NURSING IMPLICATIONS

Assessment & Drug Effects

  • Note: Frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the patient.
  • Lab tests: Periodic postprandial blood glucose, and HbA1C. Test urine for ketones in new, unstable, and type 1 diabetes; if patient has lost weight, exercises vigorously, or has an illness; whenever blood glucose is substantially elevated.
  • Notify physician promptly for presence of acetone with sugar in the urine; may indicate onset of ketoacidosis. Acetone without sugar in the urine usually signifies insufficient carbohydrate intake.
  • Monitor for hypoglycemia (see Appendix F) at time of peak action of insulin. Onset of hypoglycemia (blood sugar: 50–40 mg/dL) may be rapid and sudden.
  • Check BP, I&O ratio, and blood glucose and ketones every hour during treatment for ketoacidosis with IV insulin.
  • Give patients with severe hypoglycemia glucagon, epinephrine, or IV glucose 10%–50%. As soon as patient is fully conscious, give oral carbohydrate (e.g., dilute corn syrup or orange juice with sugar, Gatorade, or Pedialyte) to prevent secondary hypoglycemia.

Patient & Family Education

  • Learn correct injection technique.
  • Inject insulin into the abdomen rather than a near muscle that will be heavily taxed, if engaged in active sports.
  • Notify physician of local reactions at injection site; may develop 1–3 wk after therapy starts and last several hours to days, usually disappear with continued use.
  • Do not change prescription lenses during early period of dosage regulation; vision stabilizes, usually 3–6 wk.
  • Note: Hypoglycemia can result from excess insulin, insufficient food intake, vomiting, diarrhea, unaccustomed exercise, infection, illness, nervous or emotional tension, or overindulgence in alcohol.
  • Respond promptly to beginning symptoms of hypoglycemia. Severe hypoglycemia is an emergency situation. Take 4 oz (120 mL) of any fruit juice or regular carbonated beverage [1.5–3 oz (45–90 mL) for child] followed by a meal of longer-acting carbohydrate or protein food. Failure to show signs of recovery within 30 min indicates need for emergency treatment.
  • Carry some form of fast-acting carbohydrate (e.g., lump sugar, Life-Savers or other candy) at all times to treat hypoglycemia.
  • Check blood glucose regularly during menstrual period; loss of diabetes control (hyperglycemia or hypoglycemia) is common; adjust insulin dosage accordingly, as prescribed by physician.
  • Notify physician of S&S of diabetic ketoacidosis.
  • Continue taking insulin during an illness, go to bed, and drink noncaloric liquids liberally (every hour if possible). Consult physician for insulin regulation if unable to eat prescribed diet.
  • Avoid OTC medications unless approved by physician.
  • Do not breast feed while taking this drug without consulting physician.

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