Chart Flashcards
2nd Generation Sulfonylureas Examples
Glipizide (Glucotrol)
Glyburide (Glynase)
Glimepiride (Amaryl)
2nd Generation Sulfonylureas Action
Works to increase output of insulin by beta cells in pancreas
2nd Generation Sulfonylureas Nursing Implications
- Best taken 30 min prior to meal
- Main potential side effects: hypoglycemia with delayed or skipped meals or alcohol
- Use cautiously in elderly
Metformin Classification
Biguanide
Insulin Nursing Implications
- Monitor blood sugar level
- When mixing, draw rapid acting first (clear before cloudy)
Very Rapid Acting Insulin (examples & nursing implication)
Lispro (Humalog)
Aspart (Novalog)
-Clear solution
-Give 15 before meal
Very rapid acting insulin onset, peak, duration
- Onset: 10 min
- Peak: 1 hr
- Lasts: 3-4 hrs
Short (rapid) acting insulin (example & nursing imp)
Regular (R) insulin
- Clear solution
- Give 30 min before meal
Short (rapid) acting insulin onset, peak, duration
- Onset: 30 min
- Peak: 3-5 hr
- Lasts: 6-10 hrs
Intermediate acting insulin (examples and nursing imp)
NPH insulin
Lente
-Cloudy solution
-Rotate prior to use
Glargine (Lantus)
- LONG ACTING
- Clear solution
- Do NOT mix with others
- Onset: 1 hr
- NO peak
- Lasts: 24 hrs
Detemir (Levemir)
- LONG ACTING
- Clear solution
- Do NOT mix with others
- Onset: 3-4 hrs
- NO peak
- Lasts: 24 hrs
Metformin (Glucophage) Action
- Decrease liver output of sugar
- Increase peripheral insulin sensitivity
Metformin (Glucophage) Nursing Imp.
- Kidney surveillance testing required (monitor creat)
- Contraindications: CHF, alcohol abuse, metabolic acidosis, liver or kidney disease, or > 80 yrs old
- Side effects: GI distress, diarrhea, lactic acidosis
- Take WITH food
- Discontinue after OR, dye (contrast) studies for 48 hrs or until kidney function normal
Anytime Plasma Glucose Level
- Screen for diabetes
- Normal: < 200 mg/dL
Anytime Plasma Glucose Level (interpretation)
- Increased in: diabetes, acute stress reaction, severe liver disease, pancreatitis, severe renal disease
- Decreased in: hypoglycemia, excessive insulin, cancer, malnutrition, alcohol use, liver disease
Anytime Plasma Glucose Level (nursing imp)
- Assess nutritional status
- Encourage proper body weight
- Monitor blood glucose
Fasting plasma glucose level
- Screen for diabetes
- Normal: 70-100 mg/dL