ULM Nursing Critical Meds

136-145 mEq/L

1.8 -2.6 mg/dL

96-106 mEq/L

3.5 – 5.2 mEq/L

8.8-10.4 mg/dL

70-110 mg/dL

Glycosylated hemoglobin (HgbA1C)

2.7-4.5 mg/dL

6-20 mg/dL

0.6-1.2 mg/dL

Cholesterol total
140-199 mg/dL


12-17.4 g/dL

140-400 μL

11-13 seconds

INR ,Non-anticoagulant consuming

INR ,Warfarin consumer

INR High risk

21-35 seconds

Rapid Acting Insulin specific drug
aspart (Novolog)
lispro (Humalog)
glulisine (Apidra)

Rapid Acting Insulin Onset
<15 minutes

Rapid Acting Insulin Peak
1-3 hrs

Rapid Acting Insulin Duration
3-5 hrs

Short Acting Insulin Specific drugs
Humulin R (Regular)
Novolin R (Regular)

Short Acting Insulin Onset

Short Acting Insulin Peak

Short Acting Insulin Duration

Intermediate Acting Insulin Specific Drug
Humulin N (NPH)
Novolin N (NPH)
(NPH = isophane insulin suspension)

Intermediate Acting Insulin Onset

Intermediate Acting Insulin Peak

Intermediate Acting Insulin Duration

Long Acting Insulin :determir Levemir Onset

Long Acting Insulin :determir Levemir Peak
3-9hrs or near peakless

Long Acting Insulin :determir Levemir Duration
Up to 24hrs

Long Acting Insulin :glargine Lantus Onset

Long Acting Insulin :glargine Lantus Peak

Long Acting Insulin :glargine Lantus Duration
Up to 24hrs

Name the three characteristics of insulin.
Onset, Peak, Duration

When do most insulin-related, hypoglycemic reactions occur?

What are the four main classifications (types) of insulin?
Rapid, Regular (Short) Intermediate, Long

What insulins can be given intraveneous (IV)

What insulins can be given per sliding scale?
Regular & Humalog

What Insulins appear cloudy?

If drawing up NPH and Regular into the same syringe, which is drawn up first?

With any type of insulin, should 2 nurses always check the vial and the drawn up amount in the syringe prior to administering to a patient?

What is the “usual” or “normal” dosage per day of rapid acting insulin?
0.5-1units/kg/day divided by 3 doses

A patient should begin consuming their meal within how many minutes after the injection of rapid acting insulin?

What is the “usual” or “normal” dosage per day of short acting insulin
0.5-1units/kg/day divided by 3 doses

A patient should begin consuming their meal within how many minutes after the injection of short acting insulin?

What is the “usual” or “normal” dosage per day of intermediate acting insulin?
0.5-1units/kg/day divided by 3 doses

What is the “usual” or “normal” STARTING dosage per day of long acting insulin?
0.1-0.2 units/kg/day or 10 units once or twice/day; Lantus up to 100 units/day

What forms of oral potassium chloride are available?
Elixer, Efferescent tablets, capsules, tablets

Can potassium chloride be given IV?

Can potassium chloride be given IV push?

What is “normal” p.o. or IVPB potassium dosage per day?
10-20 mEq/day up to 100mEq

What is maximum infusion rate per hour for IV potassium?
10 mEq/hr

What is the antidote for warfarin (Coumadin)?
Vitamin K

What is normal beginning daily dosage for warfarin (Coumadin)?
2-5mg/day maintenance may be 2-10mg

What laboratory test is used to regulate warfarin (Coumadin)?
Pt and INR

What is heparin SQ used for?
PE and VTE prevention

How is heparin administered?
IV and SubQ

If prophylaxis for thromboembolism, what is normal SQ dosage? heparin
5000units every 8hrs

What lab test monitors efficacy of SQ Heparin?
Watch platelets H&H, Black tarry stools

What is antidote for heparin SQ or IV?
Protamine Sulfate

What is heparin IV used for?

For a continuous infusion per IV, what is the normal dosage? heparin
5000 unit bolus followed by 20,000 -40,000 units/day

How is infusion dosage titration determined/monitored?

What are some examples of low molecular weight heparin (LMWH)?
Enoxaprine, Dalteparin, Lovenox

Is there a specific lab test to titrate the dosage of low molecular weight heparin (LMWH)?
Watch CBC, Platelet count,&stools for occult blood

How is the low molecular weight heparin (LMWH) dosage derived?

What type of diuretic is furosemide Lasix?
Loop diuretic

What does furosemide Lasix excrete from the body?
Water and electrolytes

Should you assess BP and trends PRIOR to administering Lasix?

What are usual furosemide Lasix dosages?
20-80mg/day up to 600mg/day IV doses > 10mg should be diluted

What forms of digoxin (Lanoxin) are available for administration?
IM, IV, Oral

What is the daily maintenance dose range for digoxin (Lanoxin)?

Prior to giving digoxin (Lanoxin), what should you do?
check electrolytes and for the presence of bradycardia, trends

What is therapeutic range for digoxin (Lanoxin)?
0.5 -2.0 ng/mL

What are signs of toxicity of digoxin (Lanoxin)?
N/V/D Loss of appetite, visual disturbance (Halos)

If a digoxin (Lanoxin) overdose occurs, what is antidote?

warfarin sodium (Coumadin) Generic name: warfarin sodium Trade name: Coumadin Class: Anticoagulant Adult dosage: PO 2 to 5 mg/day initially; adjust daily dose according to INR determinations. Usual maintenance dosage is 2 to 10 mg/day. Therapeutic effect: anticoagulant (blood thinner), …

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