Unique Plan Description: OB Insulin Sliding Scale - NovoLOG
Plan Selection Display: OB Insulin Sliding Scale - NovoLOG
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2100-12-31 00:00:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-05-08 11:12:06
Available at all facilities: No

OB Insulin Sliding Scale - NovoLOG
Laboratory
	Glucose POC - RN
		T;N, QIDACHS
		T;N, 15 minutes after carbohydrate source or medication administered
	Glucose Level, patient to do own
		
	Hemoglobin A1C
		T+1;0400, Routine, spec type = Blood
	Order Lab
		T;N, Blood Glucose (POC) as needed for signs and symptoms of hypoglycemia for patients with diabetic medication orders or known diabetic., PRN Y/N
Medications
	Standard Dose NovoLOG
		2-12, units, Injection, SUBCUTANEOUS, QIDACHS, PRN, sliding scale, Routine
			Comment: << Sliding Scale Comments >>Under 150, Do not give any insulin150 - 199 = 2 units,200 - 249 = 4 units,250 - 299 = 6 units,300 - 349 = 8 units,350 - 399 = 10 units.Over 399 = 12 units,<< Sliding Scale Comments >> Check  POC in 3 hours; notify physician if repeat POC  greater than or equal to 400mg or less than or equal to 100.  Do not give insulin based on repeat POC value.  RN may change sliding scale insulin order and POC glucose order to every 6 hours if patient is NPO or not on oral diet (tube/enteral feedings, TPN, etc).  Enter as Q6H-SCH  PRN
	Moderate Dose NovoLOG
		4-24, units, Injection, SUBCUTANEOUS, QIDACHS, PRN, sliding scale, Routine
			Comment: << Sliding Scale Comments >>Under 150, Do not give any insulin150 - 199 = 4 units,200 - 249 = 8 units,250 - 299 = 12 units,300 - 349 = 16 units,350 - 399 = 20 units.Over 399 = 24 units,<< Sliding Scale Comments >> Check  POC in 3 hours; notify physician if repeat POC  greater than or equal to 400mg or less than or equal to 100.  Do not give insulin based on repeat POC value.  RN may change sliding scale insulin order and POC glucose order to every 6hours if patient is NPO or not on oral diet (tube/enteral feedings,TPN, etc). Enter as Q6H-SCH PRN
	High Dose NovoLOG
		5-30., units, Injection, SUBCUTANEOUS, QIDACHS, PRN, sliding scale, Routine
			Comment: << Sliding Scale Comments >>Under 150, Do not give any insulin150 - 199 = 5 units,200 - 249 = 10 units,250 - 299 = 15 units,300 - 349 = 20 units,350 - 399 = 25 units.Over 399 = 30 units, << Sliding Scale Comments >>Check  POC in 3 hours; notify physician if repeat POC  greater than or equal to 400mg or less than or equal to 100.  Do not give insulin based on repeat POC value.  RN may change sliding scale insulin order and POC glucose order to every 6hours if patient is NPO or not on oral diet (tube/enteral feedings, TPN, etc).  Enter as Q6H-SCH  PRN
Patient Care

OB Hypoglycemia Protocol
Laboratory
	Order Lab
		T;N, Blood Glucose (POC) as needed for signs and symptoms of hypoglycemia
Medications
	Dextrose 50%
		25 mL, Injection, IV Push, Q15MIN, PRN for low blood sugar, Routine
			Comment: Give if blood glucose less than 55mg/dL or 56-79 mg/dL and patient unable to tolerate oral intake. Notify provider if given with corresponding POC glucose recheck value.
	Dextrose 10% in Water (FH)
		250 mL, Injection, IVPB, Q30MIN, PRN for low blood sugar, infuse over 30 min(s)
			Comment: Give if blood glucose less than 55mg/dL or 56-79 mg/dL and patient unable to tolerate oral intake. Notify provider if given with corresponding POC glucose recheck value.
	glucagon
		1 mg, Injection, IV Push, Q15MIN, PRN for low blood sugar, Routine
			Comment: Give if blood glucose < 55mg/dL, if dextrose 50% injectable unavailable and blood glucose 56-79 mg/dL, or inadequate response to IV dextrose 50%. May give SubQ or IM if patient does not have IV access. Notify provider if given with corresponding POC glucose recheck value.
Patient Care
	IV-Maintain
		T;N
			Comment: should have IV in place for 24hr after delivery and/or patient requiring hypoglycemia treatment
	Hypoglycemia Treatment Parameters
		T;N, Hypoglycemia protocol initiated for patients with glucose <80mg/dl.
			Comment: Patient must have IV site while on hypoglycemia protocol.
		T;N, blood glucose <40mg/dl (critical value),
			Comment: Discontinue any insulin infusion and treat with Dextrose 50%, 25 ml. Notify physician immediately and repeat glucose 15 minutes after treatment
		T;N, glucose 40-55 mg/dL give Dextrose 50% 25 mL.
			Comment: Discontinue any insulin infusion and treat with Dextrose 50%, 25 ml. Notify physician immediately and repeat glucose 15 minutes after treatment
		T;N, glucose 56-79 mg/dL,
			Comment:  if Patient asymptomatic, recheck blood glucose in 30 minutes.  If symptomatic, administer 4 oz apple juice.  If patient NPO or unable to tolerate oral intake, give Dextrose 50%, 25ml.  Repeat glucose in 15 minutes after treatment
		T;N
			Comment: Give 1 complex carb and 1 protein snack or patient meal if patient able to take orals any time hypoglycemia is treated.
		T;N
			Comment: When blood glucose is greater than 100 mg/dL; if indicated, restart Insulin infusion at ½ previous rate and change glucose checks to every hour until glucose is in the target range (101 - 140) for 6 hours, then may change to Q2H glucose checks.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase