NSG 6320 AGNP Board Exam – Endocrinology Prescription Exam When patients administer regular insulin (Humulin R U-500), they should be taught:
5 units... [Show More] of Humulin R U-500 is equal to 10 units on a U-100 insulin syringe.
10 units of Humulin R U-500 is equal to 5 units on a U-100 insulin syringe.
10 units of Humulin R U-500 is equal to 10 units on a U-500 insulin syringe. Correct
it should only be used in an insulin pump.
U-500 insulin is a concentrated form of insulin containing 500 units of insulin per mL.
U-500 regular insulin vials are to be used only in conjunction with a dedicated U-500
insulin syringe; dosage conversion is not required with the U-500 syringe. When using a
U-100 syringe or a tuberculin syringe to deliver Humulin R U-500 (from vial), a
conversion step is required to ensure the correct amount of Humulin R U-500 is drawn
up in the syringe. To avoid dosing errors when using a U-100 insulin syringe, the
prescribed dose should be written in actual insulin units and as unit markings on the U-
100 insulin syringe (e.g., Humulin R U-500 50 units = 10 units on a U-100 insulin
syringe). For safety, ONLY the U-500 syringe should be used. It is not recommended for
use in insulin pumps due to possibility of precipitation.
Patients taking thiazolidinedione (TZD) medications should be monitored for:
diarrhea and flatulence.
fluid retention and weight gain. Correct
hypotension and dizziness.
weight loss and fatigue.
Thiazolidinediones including pioglitazone hydrochloride (Actos), may precipitate or
exacerbate heart failure in some patients by causing dose-related fluid retention. After
initiation of pioglitazone tablets, and after dose increases, monitor patients carefully for
signs and symptoms of heart failure (e.g., excessive, rapid weight gain, dyspnea,
and/or edema). If heart failure develops, pioglitazone should be discontinued or
dosage reduced. Pioglitazone tablets are not recommended in patients with
symptomatic heart failure. Initiation of pioglitazone hydrochloride in patients with
established New York Heart Association (NYHA) Class III or IV heart failure is
contraindicated. [Show Less]