Blood Glucose/ Insulin Administration Flashcards

Question

Why are some insulins clear and some cloudy?

Answer 1

Most insulins are clear, colorless liquids, but some intermediate-acting ones are cloudy. The cloudiness comes from added substances used as buffers (usually zinc or isophane) that make them work over a longer time

Answer 2

Cloudy insulin is usually longer acting insulin. Clear insulin is often shorter acting but can be longer acting

Answer 3

You can use both a clear and a cloudy insulin in the same syringe but need to draw, and verify, the clear insulin before drawing up the cloudy insulin

Answer 4

Usually insulin is given 1 - 4 times per day Long-acting or Intermediate-acting insulin once or twice a day (eg. before breakfast and bedtime) Rapid or short-acting before meals Or a combination of both

Answer 5

Required to cover rise in blood glucose between meals and overnight Calculation depends on weight (dose estimated at 1/2 of TDD) Includes long-acting and intermediate-acting insulins eg. NPH (20 units SC ac breakfast and ac supper), glargine (Lantus), degludec (Tresiba)

Answer 6

Required to cover rise in blood glucose due to meals May use the pre-admission meal (bolus) dose Usually ½ of TDD divided equally amongst the three meals eg. Aspart 6 units SC before meals

Answer 7

Sometimes a pre-mixed insulin is used Mix 25 Humalog (Contains both long-acting and short-acting insulin) Eg. Lispro 25% and Lispro Protamine 75%

Answer 8

Physician chooses no insulin correction or mealtime/hs correction Additional insulin added to the meal (bolus) dose to correct elevated blood sugars, based on how sensitive a patient is to insulin Used alone (q4h) if patient is NPO (see PPO for NPO)

Answer 9

Physician chooses ISF for the client based on the client’s sensitivity to insulin (so the higher the ISF, the more sensitive the client is to insulin eg. requires less insulin):

Answer 10

The blood glucose drop in mmol/l per unit of insulin given By knowing the ISF you can calculate how much insulin will decrease blood sugar ISF 1 = 1 unit of insulin will decrease BS by 1 mmol (eg. need more to do less) ISF 2 = 1 unit of insulin will decrease BS by 2 mmol ISF 3 = 1 unit of insulin will decrease BS by 3 mmol ISF 4 = 1 unit of insulin will decrease BS by 4 mmol (eg. need less to do more)

Answer 11

ISF Calculation = 100 divided by TDD eg. If the total daily dose is 50: 100 = ISF of 2 50

Answer 12

- needle length is usually determined by assessment of a client’s adipose tissue but generally an insulin pen needle is 4 mm – 12 mm (5/32 -1/2 inch) - the angle of insertion is usually 90 degrees (though 45 degrees is also acceptable for a SC injection)

Answer 13

only small doses (0.5 - 1 mL) of water-soluble medications should be given subcutaneously (but up to 2 mL is safe)

Answer 14

the outer aspect of the upper arms, anterior and lateral portions of the thigh, buttocks and abdomen

Answer 15

clients with diabetes that inject insulin should practice intrasite rotation (rotating injection sites within the same body part to provide better consistency in the absorption of insulin and subsequent injections should be given at least 2.5 cm away from the previous site)

Answer 16

disinfection of the injection site is not usually required In the home, clients often do not use an alcohol swab for subcutaneous injections In a facility, alcohol swabs may be used prior to injections to prevent infection (FIT Canada)

Answer 17

Better glycemic control (result of shorter needle length availability) Increased medication adherence rates Fewer hypoglycemic events Reduced risk of medication errors Improved self-management education (insulin pen devices are rated higher in terms of patient preference) Cost-savings (converting to insulin pen devices results in overall cost savings to the institution) Improved safety for health care workers (reduced risk of needle stick injuries and associated costs) Possible decreased insulin waste and decreased nursing time