Based on the information given, calculate Mrs. C's initial insulin dose and divide it into three injections. Indicate the appropriate amount of NPH and R to be given in each of the three doses
The following calculations are based on the method adapted from Jovanovic-Peterson and Peterson1 as reported by Carr and Gabbe2.
Her pregnant weight was 81.8 kg. She is in her 27th week of gestation. Therefore, her insulin dose will be calculated at the rate of 0.9 U/kg of body weight. Her total insulin dose would be: 0.9 × 81.8 = 73.62.
4/9 of the total insulin would be given each A.M. as NPH.
4/9 × 74 = 33 U of NPH
2/9 of the total insulin would be given each A.M. as R.
2/9 × 74 = 16 U of R
1/6 of total insulin would be given as NPH at bedtime.
1/6 × 74 = 12 U of NPH
The same dose of R insulin, 12 U, would be given at bedtime.
Therefore, Mrs. C's would receive 2/3 of her total insulin dose at the A.M. injection, and 1/3 at the hs injection. This would be 49 U at A.M. and 24 U at hs for a total of 73 U.
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