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Flashcards in IV Insulin Treatment Deck (21)
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what are the indications of IV treatment in patients with diabetes

acute illness, DKA, Hyperosmolar hyperglycaemic state(HHS), patients fasting or unable to take orally, some antenatal taking on high dose steroids


what patients is IV insulin generally not suitable for

in well patients who are eating and drinking


describe how there can be a risk of insulin omission

IV insulin has very short half life of 5mins, so if infusion is inadvertently disconnected risk of omission


what complication can arise from insulin omission

diabetic ketoacidosis


what type of chart is insulin prescribed on

the main drug kardex


what information is written on the main drug kardex when prescribing insulin

highlights continual infusion over 24 hours


what information is written on an IV insulin prescription chart

variable rate of insulin


describe how to prepare an IV insulin solution if there isn't a pre-filled syringe available

use an insulin syringe to add 50 units of soluble insulin in 495ml 0.9% sodium chloride


describe what adjustable variable rate insulin infusion is

insulin doses administered based on blood glucose levels, standard scale doesn't fit all


how is the risk of developing DKA reduced in patients, who usually prescribed multiple daily injection regimes, now receiving IV insulin treatment

should continue there prescription for long acting basal insulin subcutaneous injection while receiving IV insulin


when is scale 1 used in variable rate insulin infusion, also known as a sliding scale

standard insulin scale initially commenced


describe when is scale 2 used in variable rate insulin infusion, also known as a sliding scale

if scale 1 fails to control glucose level and is still too high, amount of insulin should be increased and scale 2 used
(eg if patient insulin resistant)


describe when is scale 3 used in variable rate insulin infusion, also known as sliding scale

if there is hypoglycaemia on scale 1, or if total daily amount of insulin is less than 24 units a day
scale 3 = reduced amount of insulin
(eg if patient insulin sensitive)


describe when is scale 4 used in variable rate insulin infusion, also called sliding scale

scale 4 can be used to create a scale for individual needs


what 2 valves should be used to ensure both IV fluid and insulin remain infusing safely

anti-syphon valve and anti-reflux valve


when might meal time insulin be given alongside IV insulin, which it isn't normally

following DKA or in some antenatal patients


when transferring from IV to subcutaneous insulin when and what should be given

stop IV insulin 30-60mins after both subcutaneous fast and long acting basal insulin has been given


when transferring from IV to subcutaneous insulin when and what should be given for those on fixed mixed insulin

stop IV 30-60 mins after fixed mixed insulin been given


how often should blood glucose be checked in the first 24 hours after stopping Iv insulin

minimum of 4 times daily


when can a patient be transferred back to oral medication

when clinically stable and eating food/drinking


what are the 5 key targets for IV insulin treatment

hourly blood glucose monitoring, target blood glucose 6-12, avoid hypoglycaemia, daily U&Es, safe transfer from IV to oral