In North Carolina, an LPN makes a home visit to a 32-year-old man with type 1 diabetes, three weeks after appendectomy. His established plan includes prescribed basal insulin, premeal glucose checks with an individualized target of 90–140 mg/dL, and a separate ordered correction-insulin scale. Recent fasting readings were 100–120 mg/dL. His wife says a relative who is a nursing assistant suggested doubling the basal dose because he was thirsty yesterday. No dose has been changed. Today glucose is 118 mg/dL and there are no new symptoms. What should the LPN do?
- Reinforce using only the ordered doses and report the proposed change and current findings to the RN or prescriber for review.
- Document 118 mg/dL as within target and omit the family’s dosing concern from the report.
- Independently revise the nursing care plan and basal-insulin schedule to incorporate the relative’s advice.
- Advise trying twice the basal dose once and deciding from tomorrow’s glucose whether to continue.