insulin injection
Patient instructed Humalog (insulin lispro) is a fast-acting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours. It is used to improve blood sugar control in patients with DMII. Most people who take Humalog use a sliding scale or take a certain dose routinely throughout the day. If you are taking this medication with meals, use it within 15 minutes before or just after you eat. Do not take Humalog if your blood sugar is below 60 or you are experiencing s/s of hypoglycemia.
Patient was instructed on how to inject. Injecting at the proper depth is an important part of good injection technique. If injected too deep, the insulin could go into muscle, where it
Caregiver was instructed that insulin is absorbed at different speeds depending on where are inject, so it's best to consistently use the same part of the body for each of the daily injections. For example, do not inject the lunch bolus dose in the abdomen on Monday and in the thigh on Tuesday. If you have picked the thigh for your evening injection, then continue to use the thigh for all of the evening injections.
SN explain about a couple of things going on that make your glucose rise in the morning. One of these is insulin resistance, a condition that means your body's muscle and fat cells are unable to use insulin effectively to lower blood glucose. However, insulin resistance also affects how your liver processes, stores, and releases sugar, particularly at night. The liver is supposed to release small amounts of glucose when you're not eating. But in type 2 diabetes, the liver dumps more glucose than is needed into the bloodstream, especially at night. So, while your hormones are causing a natural rise in blood glucose, your liver is releasing even more sugar into your system. Because your insulin resistance prevents your muscle and fat cells from using the sugar, your blood glucose level rises.
SN instructed pt on high risk med Basaglar KwikPen Subcutaneous Do not take Basaglar during episodes of low blood sugar or if you are allergic to insulin glargine or any of the ingredients in Basaglar. Do NOT reuse needles or share insulin pens, even if the needle has been changed.The most common side effect of insulin, including Basaglar, is low blood sugar (hypoglycemia), which may be serious and life threatening. Signs and symptoms may include dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood change, or hunger.
Patient was instructed on how to remove bubble from the syringe. Draw up the insulin slowly and steadily. When bubbles are forming in the syringe means that the drawing has been done too fast, so push the insulin back into the bottle and re-draw. Patient was told to do this many times as needed until the bubbles are gone.
Patient is unable to performed insulin injection by herself due to low vision and hand tremors. No caregiver able/willing to do that procedure due to ALF's policies. Nurse will continue search a c/g able and willing to administer insulin to patient.
SN instructed patient / caregiver regarding medication Lovenox. SN informed patient / caregiver that Lovenox prevents clots from forming in the blood stream. SN instructed to keep prefilled syringes in room temperature 59 - 86°F. SN instructed patient / caregiver on proper administration of Lovenox and provided handout. SN informed that the most common side effect associated with Lovenox is bleeding. SN instructed to call Physician ( MD ) if patient / caregiver experiences any increased pain or symptoms / signs ( s / s ) of internal bleeding. SN Informed that a mild local irritation, pain, hematoma, ecchymosis, and erythema may occur at the site of injection. SN instructed to rotate injection sites around abdomen.
SN explained to patient that Lovenox is to be administered as one pre-filled syringe by deep subcutaneous injection in the abdominal fat. Only one shot is administered in the morning and one shot is administered at night for physician ordered specific number of days. SN instructed patient on technique and importance of rotating injection sites around abdomen.
Patient was instructed on taking insulin on sick day. If having trouble eating solid food, drink fruit juices, non diet soft drinks, or clear soups, or eat small amounts of bland foods. The body needs to have its usual insulin dose especially if having nausea or vomiting. If having severe or prolonged vomiting check with the doctor or nurse. Even when starting feeling better let the doctor to know about it.