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T. R. is admitted to the local hospital for treatment of the foot ulcer. Based on the result of T. R. ‘s Hgb AIC and random glucose, it is recommended to start her on insulin while hospitalized. She is prescribed NPH (Humulin N) twice a day at 0800 and 2000. In addition, she is on a sliding scale with human lispro insulin three times a day before breakfast, lunch, and dinner. Discuss these 2 medications on administration concerns, side effects, pharmacokinetics, and explain sliding scale. (Provide rationales with in-text citations and a combined reference list at the end of this document in APA format.) Humulin N is an intermediate acting form of insulin that takes effect in 2-4 hours, peaks between 4-12 and will continue to work 12-18 hours after administration (Sinah, 2023). The most common side effect of NPH (Humulin N) is low blood sugar. Low blood sugar can present as symptoms such as sweating, pale skin, hunger, irritability, dizziness and trouble concentrating. Other side effects of Humulin N can be fluid retention, low potassium, especially in your hands and feet, and itching or a rash at the injection site (Sinah, 2023). This medication is to be administered using either an insulin needle or a prescribed insulin pen, and it is to be injected into the subcutaneous skin layer. Administering this medication it is important to rotate injection sites, as repeatedly injecting in the same site can cause thickening or possibly even hollowing of the skin where the medication is injected (Sinah, 2023). With Humulin N being an intermediate acting insulin, it will be administered as a set dose at a set time, and should always be administered as a subcutaneous injection, and never orally or IV. Human Lispro is another type of insulin and is similar to humulin N. However there are some differences. Human Lispro is considered a fast-acting insulin and as such works quicker, yet shorter than that of humulin N. Lispro starts working about 15 minutes after being administered. It will peak within an hour and will continue to work for 2 to 4 hours (Thornton, 2023). Lispro has similar side effects to that of Humulin N. The most common and a major side effect is low blood sugar. Other possible side effects are low potassium, weight gain, swelling in the hands and feet, and itching (Thornton, 2023). With Lispro being a fast acting insulin and being used on a sliding scale it will be administered before meals, and the dose that is given will vary. Sliding scale insulin coverage works, by taking the blood sugar of the patient before giving the lispro. The dose of lispro varies on how high the patients blood sugar is, the higher their blood sugar the higher dose of lispro is required to help cover their blood sugar.The sliding scale is determined by the doctor, and they will decide the range and the units given to the patient based on their needs (Harding, 2023, p1113. Do a peer review on the above
SCIENCE
HEALTH SCIENCE
NURSING

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