What is KK's renal function?
What is KK's HgbA1c?
What is KK's weight?
Was KK on hypoglycemics at home prior to admission?
Are there any medications that are causing KK's BG to be so high?
Is KK receiving nutrition?
What hyperglycemia treatment is KK currently receiving?
Does KK has a history of diabetes?
Add correctional insulin.
Lantus 39 units Q24h is not enough for a patient who is on an insulin infusion @ 6-12 units/hr, so you should page the MD and offer to have pharmacy dose this patient's insulin.
Verify the order.
Lantus 39 units Q24h is not enough for a patient who is on an insulin infusion @ 6-12 units/hr, so you should page the MD and recommend a higher dose.
Lantus 10 units Q24h
Lantus 20 units Q24h
Lantus 40 units Q12h
Lantus 79 units Q24h
Lantus 158 units Q24h
1 hour before the first dose of Lantus is administered
As soon as the first dose of Lantus is administered
1 hour after the first dose of Lantus is administered
2 hours after the first dose of Lantus is administered
Lispro 5 units TIDAC
Lispro 5 units Q6h
Lispro 12 units TIDAC
Lispro 13 units Q4h
Lispro 20 units Q6h
Fingersticks to correlate with prandial insulin
Time insulin infusion to end 2 hours after first dose of Lantus is scheduled
D/C Q1h fingersticks from insulin infusion
Increase prandial lispro to 20 units Q4h
No adjustments since 1 day is not enough time to assess response to insulin regimen
Increase prandial lispro to 16 units Q4h
Increase correctional insulin to 2-8 units prn BG >150mg/dL
Increase Lantus to 50 units Q12h
Increase Lantus to 80 units Q12h
His uncontrolled diabetes
Stress from acute illness
His propofol infusion
Phos replacements on the critical care electrolyte replacement protocol