Antidiabetics

Question 1

Type 1 diabetes

Answer 1

AKA juvenile
Insulin-dependent DM
Autoimmune disease: attacks the pancreas

Question 2

Type 2

Answer 2

non-insulin-dependent DM

Question 3

Secondary type

Answer 3

Due to medications (glucocorticoids, thiazide diuretics, epinephrine)

Question 4

Gestational diabetes

Answer 4

Hormonal changes

Question 5

Why is DM bad

Answer 5

High blood sugar damages blood vessels and nerves→vision changes and decreased blood flow

Question 6

Function of insulin

Answer 6

moves glucose into the cells
Promotes uptake of glucose, amino acids, and fatty acids
Converts glucose to glycogen in liver and muscle for future glucose needs

Question 7

Normal range blood glucose

Answer 7

70-100

Question 8

What is a combination insulin type

Answer 8

Composed of short- and intermediate-acting or rapid- and intermediate-acting (minimize how many times patient is being poked)
(Ex. NPH 70/regular 30. NPH 50/regular 50)

Question 9

Storage of insulin

Answer 9

Keep in refrigerator until opened.
Avoid storing insulin in direct sunlight or at high temperatures.
Once opened it’s good for a month
Once opened and in a fridge it’s good for 3 months

Question 10

What is sliding scale insulin

Answer 10

Adjusted doses dependent on individual blood glucose
For rapid or short acting

Question 11

When to monitor blood glucose

Answer 11

before meals and at bedtime

Question 12

Insulin side effects

Answer 12

Nervousness, tremors
Headache, confusion, lack of coordination
Cold, clammy skin

Question 13

Insulin adverse reactions

Answer 13

Hypoglycemia, insulin shock
Diabetic ketoacidosis: hyperglycemia

Question 14

Treatment of adverse reactions

Answer 14

Juice (PO): can swallow
Dextrose (IV): unconscious.
Glucagon (IV or IM): Raises blood sugar. Tells the body to make its own glucose
(Have IV administer glucose
Don’t have IV administer glucagon)

Question 15

What is the somogyi effect

Answer 15

Rapid decrease in blood glucose during night stimulates hormonal release to increase blood glucose

Question 16

What is the dawn phenomenon

Answer 16

Hyperglycemia upon awakening

Question 17

S&S of dawn phenomenon

Answer 17

Headache, night sweats, nightmares

Question 18

What is lipodystrophy

Answer 18

tissue gets firm and painful
Lipoatrophy
Lipohypertrophy

Question 19

Glipzide, glimepiride
MOA
Use

Answer 19

Make more insulin
Treat type 2 diabetes

Question 20

Side effects of glipizide, glimepiride

Answer 20

Hypoglycemia
GI distress, weight gain
Nervousness, tremors, confusion

Question 21

Metformin
MOA

Answer 21

Reduces glucose production
Decreases glucose absorption from small intestine
Increase insulin receptor sensitivity

Question 22

Criteria for use of oral antidiabetic drugs

Answer 22

Onset of diabetes mellitus at age 40 years or older
Diagnosis of diabetes for less than 5 years
Normal weight or overweight
Fasting blood glucose 200 mg/dL or less
Less than 40 units of insulin required per day
Normal renal and hepatic function

Question 23

Nursing interventions

Answer 23

Administer oral antidiabetics with food to minimize gastric upset.
Monitor blood glucose levels and report changes.
Teach patient to recognize symptoms of hypoglycemia and hyperglycemia.
Teach patient necessity of adherence to diet and drug regimen.

Question 24

Which time frame would be most appropriate for administering sliding-scale lispro insulin?

A. Within 30 minutes of consuming breakfast
B. When the breakfast tray is served and ready to eat
C. Within 1 hour of obtaining blood glucose measurement
D. Within 15 minutes of obtaining blood glucose measurement

Answer 24

B. When the breakfast tray is served and ready to eat

Question 25

A patient received regular insulin at 7:30 am. At 9:30 am the patient feels slightly hungry and has a dull headache. The nurse should A. test the patient’s blood glucose level. B. ensure that the patient has a meal. C. provide the patient with 4 ounces of orange juice. D. administer the next dose of insulin.

Answer 25

A. Test the pt's blood glucose level

Question 26

Which statement by a patient taking glipizide indicates that more teaching is indicated? A. “I will use a new needle every time I take the medication.” B. “I will take the medication once a day in the morning.” C. “I will eat my breakfast very soon after taking my glipizide.” D. “This medication stimulates my pancreatic cells to make insulin.”

Answer 26

A. I will use a new needle every time I take the medication

Question 27

When teaching the patient about the storage of insulin, which statement will the nurse include? A. Keep the insulin in the freezer. B. Warm the insulin in the microwave before administration. C. Do not place insulin in sunlight or a warm environment. D. Open insulin vials lose their strength after one year.

Answer 27

C. Do not place insulin in sunlight or a warm environment

Question 28

A patient with type 1 diabetes mellitus is ordered insulin therapy once daily to be administered at bedtime. What is the type of insulin the patient is most likely receiving? A. Insulin glargine B. Lente insulin C. Lispro insulin D. Regular insulin

Answer 28

A.Insulin glargine

Question 29

Insulin lispro (humalog) Type of insulin Onset Peak Duration

Answer 29

Rapid-acting 15-30 min 30-90 min 3-5 hours

Question 30

Insulin Aspart (novalog) Type of insulin Onset Peak Duration

Answer 30

Rapid acting 10-20 min 40-50 min 3-5 hours

Question 31

Regular insulin Type of insulin Onset Peak Duration

Answer 31

Short-acting 30-60 min 2-3 hr 5-7 hr

Question 32

NPH type of insulin Onset Peak Duration

Answer 32

Intermediate-Acting 1-1.5 hr 8-12 hrs 18-24 hrs

Question 33

Glargine Type of insulin Onset Peak Duration

Answer 33

Long-acting 1-1.5 hour DNE 24 hrs