The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
A.
Insulin is never given intravenously.
B.
Only regular insulin can be administered intravenously.
C.
Insulin aspart or insulin lispro can be administered intravenously, but there must be a 50% dose reduction.
D.
Any form of insulin can be administered intravenously at the same dose as that ordered for subcutaneous administration.
The correct answer and Explanation is :
The correct answer is:
B. Only regular insulin can be administered intravenously.
Explanation:
Intravenous (IV) insulin administration is generally reserved for specific clinical situations, such as the treatment of diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), or perioperative management of diabetes in hospitalized patients. It is an effective way to achieve rapid blood glucose control, but not all types of insulin are suitable for IV administration.
1. Regular insulin:
The only insulin type approved for intravenous use is regular insulin. This is because of its predictable onset, peak, and duration when administered intravenously. Regular insulin, when given IV, has an immediate onset of action, and the effects can be precisely titrated to the patient’s blood glucose levels, making it ideal in acute settings where tight glucose control is required. It typically begins working within minutes and has a half-life of approximately 9 minutes when administered intravenously.
2. Other insulins (e.g., insulin aspart, insulin lispro):
Rapid-acting insulins like insulin aspart (Novolog) or insulin lispro (Humalog) are typically used for subcutaneous administration due to their pharmacokinetics. While these rapid-acting insulins work quickly when given subcutaneously, they are not approved or routinely used for IV administration. This is largely due to a lack of sufficient data supporting their use via this route, and the possibility of unpredictable effects.
3. Safety Concerns:
It is crucial to note that not all forms of insulin have been studied or approved for IV use. Administering insulin IV incorrectly can result in significant hypoglycemia, a potentially life-threatening condition.
In summary, only regular insulin should be administered intravenously in clinical practice, due to its predictable behavior and safety profile.