Question

The nurse is taking care of a client preoperatively. The client is NPO and tells the nurse that he takes detemir insulin (Levemir) and aspart insulin (NovoLog) at 0700 daily. The client's surgery is scheduled for 0900. Which is the best action for the nurse to take?

Answer 1

Hold the insulin. NPO means they havent eaten and can not eat before surgery. The novolog is a fast acting insulin and the client would need to eat when taking it. The levemir should also be held because it is unclear as to how long it would be before the patient would be able to eat again. 

Answer 2

Being an NPO patient implies that for the surgery the patient cannot eat food, for this reason what the nurse can do is they day before the surgery she can give the Novolog patient (fast action) the usual dose in the same way as it is administered in the morning The levemir that is slow acting can be administered normally. On the day of surgery, a glycemic profile is recommended and Novolog should be discontinued. Levemir should be administered in a lower percentage of the usual dose.