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    In Partial Fulfillment of The Requirements in Critical Carenursing

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    Mary Rose Silva Gargar
    The document provides information about calculating insulin doses including total daily insulin requirement, basal/background insulin dose, and bolus insulin doses for carbohydrate coverage and high blood sugar correction. Formulas are given for calculating doses based on weight in pounds or kilograms.

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    © All Rights Reserved
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    In Partial Fulfillment of The Requirements in Critical Carenursing

    Uploaded by

    Mary Rose Silva Gargar
    12 views3 pages
    The document provides information about calculating insulin doses including total daily insulin requirement, basal/background insulin dose, and bolus insulin doses for carbohydrate coverage and high blood sugar correction. Formulas are given for calculating doses based on weight in pounds or kilograms.

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    The document provides information about calculating insulin doses including total daily insulin requirement, basal/background insulin dose, and bolus insulin doses for carbohydrate coverage and high blood sugar correction. Formulas are given for calculating doses based on weight in pounds or kilograms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    12 views3 pages

    In Partial Fulfillment of The Requirements in Critical Carenursing

    Uploaded by

    Mary Rose Silva Gargar
    The document provides information about calculating insulin doses including total daily insulin requirement, basal/background insulin dose, and bolus insulin doses for carbohydrate coverage and high blood sugar correction. Formulas are given for calculating doses based on weight in pounds or kilograms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    ST.

    PAUL UNIVERSITY DUMAGUETE


    COLLEGE OF NURSING
    A.Y. 2nd SEMESTER 2020-2021

    IN PARTIAL FULFILLMENT OF THE REQUIREMENTS

    IN

    Critical CareNursing

    Submitted To:

    Mrs. Maria Lourdes Agustin, RN

    Submitted By:

    Ana Marie Quiñonez

    Date of Submission:

    February 11, 2021


    ST. PAUL UNIVERSITY DUMAGUETE
    COLLEGE OF NURSING
    A.Y. 2nd SEMESTER 2020-2021

    First, some basic things to know about insulin:


    Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting
    and between meals. This is called background or basal insulin replacement. The basal or background
    insulin dose usually is constant from day to day.
    The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar
    correction. This is called the bolus insulin replacement.
    Bolus – Carbohydrate coverage

    The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to
    carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of
    insulin.

    Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can
    vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin
    sensitivity can vary according to the time of day, from person to person, and is affected by physical
    activity and stress.

    Bolus – High blood sugar correction


    (also known as insulin sensitivity factor)

    The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin
    will drop the blood sugar.

    Total Daily Insulin Requirement:


    The general calculation for the body’s daily insulin requirement is:

    Total Daily Insulin Requirement (in units of insulin)


    = Weight in Pounds ÷ 4

    Alternatively, if you measure your body weight in kilograms:

    Total Daily Insulin Requirement (in units of insulin)


    = 0.55 X Total Weight in Kilograms

    Example 1:

    If you are measuring your body weight in pounds:

    Assume you weigh 160 lbs.


    In this example:

    TOTAL DAILY INSULIN DOSE


    = 160 lb ÷ 4 = 40 units of insulin/day

    Example 2:
    ST. PAUL UNIVERSITY DUMAGUETE
    COLLEGE OF NURSING
    A.Y. 2nd SEMESTER 2020-2021
    If you are measuring your body weight in kilograms:

    Assume your weight is 70Kg


    In this example:

    TOTAL DAILY INSULIN DOSE


    = 0.55 x 70 Kg = 38.5 units of insulin/day

    If your body is very resistant to insulin, you may require a higher dose. If your body is sensitive to insulin,
    you may require a lower insulin dose.

    Basal/Background and Bolus Insulin Doses


    Next, you need to establish the basal/background dose, carbohydrate coverage dose (insulin to
    carbohydrate ratio) and high blood sugar correction dose (correction factor).

    Basal/background insulin dose:


    Basal/background Insulin Dose
    = 40-50% of Total Daily Insulin Dose

    Example:

    Assume you weigh 160 pounds


    Your total daily insulin dose (TDI) = 160 ÷ 4 = 40 units.
    In this example:

    Basal/background insulin dose


    = 50% of TDI (40 units) = 20 units
    of either long acting insulin, (such as glargine or detemir) or rapid acting insulin if you are using an
    insulin pump (continuous subcutaneous insulin infusion device).

    The carbohydate coverage ratio:


    500 ÷ Total Daily Insulin Dose
    = 1 unit insulin covers so many grams of carbohydrate

    This can be calculated using the Rule of “500”: Carbohydrate Bolus Calculation

    In this example :

    Carbohydrate coverage ratio


    = 500 ÷ TDI(40 units)
    = 1unit insulin/ 12 g CHO

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