9 Insulin Administration & Complications

What are the common sites for subq injection of insulin?

• Upper arm

• Abdomen (fastest absorbing)

• Thigh (slowest)

What should a pt be taught when they apply insulin to themselves?

rotate injection sites (to avoid lipohypertrophy)

Which form of insulin administration is the best for those who are health literate and are able to afford a back up?

Insulin Pump

What is a major insulin adverse effect/complication?

Hypoglycemia

If Insulin levels exceed the need, what might a pt present when they are experiencing a “rapid fall”?

increased HR, sweating, shakiness

If Insulin levels exceed the need, what might a pt present when they are experiencing a “slow fall”?

HA, confusion, fatigue, drowsiness

What other major complication does hypoglycemia mimics? (should be worried bcz we dont know if the pt is experiencing either this or hypoglycemia)

stroke

What type of patients are at a higher risk for Hypoglycemia when given Insulin?

• ↓ food intake

• Vomiting/diarrhea

• ↑ exercise/activity

• Alcohol intake

• Uncontrolled diabetes

True or False: Nursing interventions when dealing with the adverse effect of hypoglycemia from Insulin depends on LOC.

True (a conscious person can have oral glucose tabs, OJ, soda, candy)

What can be used to treat hypoglycemia?

Glucagon and D50 (administration)

The following describes which hypoglycemia treatment:

• Improvement in about 20 minutes after IV administration

• Stimulates liver and releases stored [redacted]

• IV, IM, or Subcutaneously

Glucagon

The following describes which hypoglycemia treatment:

• Results almost immediately

• Usually available in a 50 cc prefilled syringe

• Viscous fluid – will be hard to push

• Push quickly (mindful of push speed)

D50 = 50% dextrose

When Insulin is administered, it promotes the uptake of glucose and what other molecule into body cells?

potassium

Why should you be worried when a patient with a history of heart complications is given insulin?

arrythmias from changed potassium levels

What lab values should you monitor for patients who are receiving high levels of insulin?

serum potassium levels

For patients receiving high levels of insulin, what supplement may they need?

potassium

Insulin may also be used to treat what other complication for pts who have a normal glucose level?

hyperkalemia