hey everyone it's Sarah register nurse rn.com and in this video I'm going to be going over our weekly inlex practice question and don't forget to check out the other questions in this series so let's take a look at our question your patient's blood glucose level is 215 milligram per deciliter the patient is about to eat lunch per sliding scale you administer four units of insulin list Pro which is Humalog subcutaneously at 11:30 as the nurse you know the patient is most at risk for hypoglycemia at what time a 11:45 B 1230 C 1430 or D 1630 so the first thing what we want to do is analyze our scenario and the first thing our scenario tells us is the patient's blood sugar which is 215 milligrams per deciliter so you should be asking yourself the following questions what is a normal blood sugar before meals what should a person run they should run anywhere between 70 to 130 milligrams per deciliter so our patient is high in their blood glucose and we want to provide them insulin coverage before they go and ether Mill because this is going to increase their blood sugar even more now the physician has ordered insulin Lis Pro which is also known as Humalog okay so think back to those days in Pharmacology what type of insulin is lispro also known as humal and you have four different types of categories of insulin so let's see what it falls into we have our rapid we have our short we have our intermediate and long okay in Rapid you have three different types we have insulin list Pro which is Humalog which is the one that we're going to be giving so we know it's rapid we have have aspart which is novalog and glulisine which is also called aedra then you have short which are all your regular insulin so any insulin name that says like humin r or novelin R we know that th those are short acting insulins then you have the intermediate ones and these are the ones that are like your n pH and anytime you see intermediate um insulin in a vial it will always be cloudy so if you see cloudy insulin know that that is an intermediate acting insulin and this includes like novelin in humin in so anything that ends with in then you have your long acting insulins which include lantis which is also known as garene insulin garene or lamir which is known as detr so we've determined that this is a rapid acting insulin now um if you need a pneumonic to help you remember all these categories along with their onet Peak and duration because that is a lot to Remember on Top of the other stuff I have a video insulin pneumonics that you can access up here in the card and it will go over those pneumonics with you so you can have some memory memory aids to help you remember this material now our question wants to know when is Hypoglycemia most likely to occur with this this rapid insulin which is Lis Pro so hypoglycemia is whenever the blood sugar drops so it gets low and Insulin works we have three things we need to remember about each insulin we need to remember their onset Peak and duration so you need to ask yourself when will hypoglycemia occur during the onset during the peak or during the duration so let's see what each are about onset is how fast this insulin is going to work Peak is when it's the strongest that has the strongest effect on the body and duration is how long that insulin is going to last so when is the patient most at risk for the blood sugar dropping during when it's the strongest has the strongest ability to get that blood sugar down which will be its peak so we need to know what the peak of this Lis Pro this rapid acting insulin is now that's where those pneumonics come into play because there's a lot to remember with those okay so let's go over it for this particular category of insulins remember this pneumonic because whenever I was in nursing school these really just gave me a fit because there was just so many numbers to remember for each category so I developed these pneumonics which are nursing specific to help us remember them because if it's something that has to do with nursing we're more likely to remember since we're going to be doing it day in and day out okay so for specifically the rapid acting insulin we have our onset our Peak and duration and this is what the pneumonic says 15 minutes feels like an hour during three rapid responses so this pneumonic tells you several things it's going to tell you the onset the peak and the duration in chronological order and it's going to tell you which category of insulin it's for which is for Rapid so the onset is 15 minutes the peak of when it's going to have the strongest effect on the body and the most risk for hypoglycemia is an hour and our duration is 3 hours so what time thinking back to our question did we give this insulin we gave it at 11:30 and our Peak is in 1 hour so they're most at risk for hypoglycemia and an hour from that which would be 1230 and these questions like to throw things at you like um the onset which is 15 minutes well we gave it at a 11:30 so 11:45 that's when the onset would be and the duration 3 hours would be 2:30 so always make sure you have these organized right in your mind so you know what the question's asking so it doesn't trick you so this wraps up this review on this inlex question be sure to check out the other questions in this series and our other videos such as our inlex lectures