Sliding Scale Insulin Flashcards

A resident's sliding scale insulin order is as follows: - 151-200 mg/dL: 2 units - 201-250 mg/dL: 4 units - 251-300 mg/dL: 6 units - >300 mg/dL: Call Nurse The QMA checks the resident's blood glucose before lunch, and the reading is 248 mg/dL. How many units of rapid-acting insulin should the QMA prepare to administer?

Answer: 4 units

The blood glucose level of 248 mg/dL falls within the 201-250 mg/dL range on the sliding scale order. According to the order, the correct dose for this range is 4 units of insulin.

Which of the following is the most critical element for a QMA to verify before administering insulin based on a sliding scale?

Answer: The resident's current blood glucose reading.

Sliding scale insulin dosage is entirely dependent on the resident's current blood glucose level. Without an accurate, current reading, the correct dose cannot be determined, and administering insulin could be dangerous.

A QMA is reviewing a new sliding scale insulin order. The order contains the following ranges: 150-200 mg/dL and 200-250 mg/dL. What is the most appropriate action for the QMA to take?

Answer: Notify the delegating RN of the overlapping blood sugar ranges in the order.

Sliding scale orders must have clear, non-overlapping ranges to prevent medication errors. An order with overlapping values (e.g., where 200 mg/dL appears in two different ranges) is ambiguous and unsafe. The QMA must report this to the RN for clarification from the prescriber.

A resident's blood glucose is 140 mg/dL. The sliding scale order states to give 0 units for blood glucose <150 mg/dL. The resident is also scheduled for a routine dose of 10 units of long-acting insulin. What should the QMA do?

Answer: Administer the 10 units of long-acting insulin only.

Sliding scale insulin is typically a supplemental, or 'correction', dose of rapid- or short-acting insulin added to a resident's routine insulin regimen. In this case, the blood sugar is below the threshold for a correction dose, so no sliding scale insulin is given. However, the standing order for the long-acting (basal) insulin should still be administered as prescribed unless there are specific orders to hold it.

The primary purpose of using a sliding scale for insulin administration is to:

Answer: Correct current hyperglycemia based on a pre-meal blood glucose reading.

Sliding scale insulin is a reactive approach that uses rapid- or short-acting insulin to correct a high blood glucose level that is already present, typically checked before a meal. It does not replace the need for basal (long-acting) insulin and is entirely dependent on current blood glucose readings.

A QMA checks a resident's blood glucose, and the result is 375 mg/dL. The sliding scale order is as follows: - 251-300 mg/dL: 6 units - 301-350 mg/dL: 8 units - Above 350 mg/dL: Call MD/RN What is the QMA's correct action?

Answer: Hold the insulin and notify the supervising nurse.

The physician's order explicitly directs the QMA to call the MD or RN for a blood glucose reading above 350 mg/dL. The QMA's scope of practice requires them to follow the order precisely and not to administer a dose that is not specified or to make an independent clinical judgment.