There will be eight questions assessing drug calculation skills in the Prescribing Safety Assessment (PSA). In contrast, the paediatric population have under-developed organ systems, and medication doses are often based on the age, weight or body surface area of the child.Ĭommon drug calculation errors in clinical practice include miscalculating the concentration of medicine in solution, incorrect dose unit conversion and incorrect rate of administration for infusion. Medication doses may need to be adjusted, as the “safe” dose for a regular adult may no longer be appropriate for them. This is particularly important when prescribing for the elderly and paediatric populations, as they are more vulnerable to medication-related harm.įrailty and reduced renal function are commonly seen in the elderly population. If your score is less than 70%, you can return to this section and review the information.Drug calculation skills are an important part of prescribing, as calculation errors may lead to significant patient harm. If your score is over 70% correct, you are doing very well. At the end of the quiz, your score will display. Please choose the single best answer to each question. To find out how much you have learned about Insulin Therapy, take our self assessment quiz when you have completed this section. Self assessment quizzes are available for topics covered in this website. You will need to work out your specific insulin requirements and dose regimen with your medical provider and diabetes team. Please keep in mind, the estimated insulin regimen is an initial “best guess” and the dose may need to be modified to keep your blood sugar on target.Īlso, there are many variations of insulin therapy. While the calculation is 1 unit will drop the blood sugar 45 mg/dl, to make it easier most people will round up or round down the number so the suggested correction factor may be 1 unit of rapid acting insulin will drop the blood sugar 40-50 mg/dl. = 1 unit insulin will drop reduce the blood sugar level by 45 mg/dl Assume your total daily insulin dose(TDI) = 160 lbs ÷ 4 = 40 units. This can be calculated using the Rule of “1800”. Example #1: Carbohydrate coverage at a mealĬorrection Factor = 1800 ÷Total Daily Insulin Dose = 1 unit of insulin will reduce the blood sugar so many mg/dl Read some examples and therapeutic principles on how to calculate the carbohydrate coverage dose, high blood sugar correction dose and the total mealtime insulin dose. This drop in blood sugar can range from 15-100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances. Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. (also known as insulin sensitivity factor) Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. This range can vary from 4-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. 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. This is called the bolus insulin replacement. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction.The basal or background insulin dose usually is constant from day to day. This is called background or basal insulin replacement. Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals.Formulas that are commonly used by providers to create insulin dose recommendationsįirst, some basic things to know about insulin:.An example of how to calculate a mealtime insulin dose.An example of how to calculate a high blood sugar correction dose.An example of how to calculate a carbohydrate coverage dose.Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. Your provider will prescribe an insulin dose regimen for you however, you still need to calculate some of your insulin doses.
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