Chart Flashcards

1
Q

2nd Generation Sulfonylureas Examples

A

Glipizide (Glucotrol)
Glyburide (Glynase)
Glimepiride (Amaryl)

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2
Q

2nd Generation Sulfonylureas Action

A

Works to increase output of insulin by beta cells in pancreas

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3
Q

2nd Generation Sulfonylureas Nursing Implications

A
  • Best taken 30 min prior to meal
  • Main potential side effects: hypoglycemia with delayed or skipped meals or alcohol
  • Use cautiously in elderly
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4
Q

Metformin Classification

A

Biguanide

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5
Q

Insulin Nursing Implications

A
  • Monitor blood sugar level

- When mixing, draw rapid acting first (clear before cloudy)

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6
Q

Very Rapid Acting Insulin (examples & nursing implication)

A

Lispro (Humalog)
Aspart (Novalog)
-Clear solution
-Give 15 before meal

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7
Q

Very rapid acting insulin onset, peak, duration

A
  • Onset: 10 min
  • Peak: 1 hr
  • Lasts: 3-4 hrs
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8
Q

Short (rapid) acting insulin (example & nursing imp)

A

Regular (R) insulin

  • Clear solution
  • Give 30 min before meal
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9
Q

Short (rapid) acting insulin onset, peak, duration

A
  • Onset: 30 min
  • Peak: 3-5 hr
  • Lasts: 6-10 hrs
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10
Q

Intermediate acting insulin (examples and nursing imp)

A

NPH insulin
Lente
-Cloudy solution
-Rotate prior to use

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11
Q

Glargine (Lantus)

A
  • LONG ACTING
  • Clear solution
  • Do NOT mix with others
  • Onset: 1 hr
  • NO peak
  • Lasts: 24 hrs
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12
Q

Detemir (Levemir)

A
  • LONG ACTING
  • Clear solution
  • Do NOT mix with others
  • Onset: 3-4 hrs
  • NO peak
  • Lasts: 24 hrs
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13
Q

Metformin (Glucophage) Action

A
  • Decrease liver output of sugar

- Increase peripheral insulin sensitivity

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14
Q

Metformin (Glucophage) Nursing Imp.

A
  • 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
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15
Q

Anytime Plasma Glucose Level

A
  • Screen for diabetes

- Normal: < 200 mg/dL

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16
Q

Anytime Plasma Glucose Level (interpretation)

A
  • Increased in: diabetes, acute stress reaction, severe liver disease, pancreatitis, severe renal disease
  • Decreased in: hypoglycemia, excessive insulin, cancer, malnutrition, alcohol use, liver disease
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17
Q

Anytime Plasma Glucose Level (nursing imp)

A
  • Assess nutritional status
  • Encourage proper body weight
  • Monitor blood glucose
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18
Q

Fasting plasma glucose level

A
  • Screen for diabetes

- Normal: 70-100 mg/dL

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19
Q

Fasting Plasma Glucose Level (interpretation)

A

100-126 mg/dL indicates prediabetes

> 126 mg/dL indicates diabetes

20
Q

Oral glucose test

A

-Screen for diabetes
-Normal: < 200 mg/dL
> 200 mg/dL indicates diabetes

21
Q

Glycosylated hemoglobin A1c (HbA1c)

A
  • Assess long-term glucose control (2-3 months)
  • Normal: < 6.0% (decreasing)
  • Increased in poorly controlled or uncontrolled diabetes
22
Q

Liver Function Tests

A
  • ALT, AST, ALP, bilirubin
  • Assess liver function and damage
  • Increased in hepatitis, liver disease, cancers, CHF
23
Q

Hepatitis A antibody, Hepatitis B antigen & antibody, Hepatitis C antibody, Hepatitis D antibody

A
  • Assess for Hepatitis A, B, C, D

- Positive results indicates hepatitis infection

24
Q

Thyroid antibodies lab (indications & interpretation)

A
  • Assist in diagnosis of Grave’s disease

- Increased in chronic thyroiditis, Grave’s disease, pernicious anemia, RA

25
Q

Thyroid hormones: T3 and T4 (Indication)

A
  • Evaluate hypo or hyper-thyroidism

- Monitor response to therapy

26
Q

Thyroid hormones: T3 and T4 (interpretation)

A
  • Increased in hyperthyroidism, thyrotoxicosis, excessive intake of iodine, hepatitis
  • Decreased in hypothyroidism
27
Q

Thyroid stimulating hormone (TSH) indication

A

-Diagnosis of hypo- or hyper-thyroidism

28
Q

TSH interpretation

A
  • Increased in: primary hypothyroidism, thyroid hormone resistance, thyroiditis
  • Decreased in: excessive thyroid hormone replacement, Grave’s disease, primary hyperthyroidism, secondary hypothyroidism
29
Q

Radioactive Iodine (RAI) Uptake Test (indication)

A
  • Evaluate hyper- or hypo-thyroidism
  • Evaluate thyroiditis, goiter, or pituitary failure
  • Monitor response to therapy for thyroid disease
30
Q

RAI Uptake Test (interpretation)

A
  • Abnormal findings in decreased iodine intake or increased iodine excretion, Grave’s disease, iodine-deficient goiter
  • Increased uptake in hyperthyroidism
  • Decrease uptake in hypothyroidism
31
Q

Albumin Lab (indication)

A
  • Assess nutritional status
  • Evaluate chronic illness
  • Evaluate liver disease
32
Q

Albumin (normal)

A

3.4-4.8 g/dL

33
Q

Albumin (interpretation)

A
  • Increased in dehydration

- Decreased in: malnutrition, liver disease, inflammation, increased blood volume, increased loss (burns, hemorrhage)

34
Q

Albumin Lab (nursing imp)

A
  • Assess nutritional status
  • Monitor for edema when levels are low
  • Assess tissue integrity and prevent skin breakdown
  • Encourage protein intake
35
Q

Prealbumin Lab (indication)

A
  • Evaluate nutritional status

- Monitor parenteral nutrition

36
Q

Prealbumin (normal)

A

12-42 mg/dL

37
Q

Prealbumin (interpretation)

A
  • Increased in: alcoholism, chronic renal failure, pts receiving steroids
  • Decreased in: malnutrition, tissue necrosis, liver disease, acute phase inflammatory responses, chronic illness
38
Q

Antithyroid Agent

A

Methimazol (Tapazole)

39
Q

Methimazol (Tapazole) Action

A

-Antithyroid agent: inhibits synthesis or thyroid hormones

40
Q

Methimazol (Tapazole) nursing imp.

A
  • Monitor thyroid function and hepatic function

- Take with meals

41
Q

Thyroid supplement

A

Levothyroixine (Synthroid)

42
Q

Levothyroxine (Synthroid) Action

A

Synthetic thyroid hormone

43
Q

Levothyroxine (nursing imp)

A
  • Give on EMPTY stomach, 1/2-1 hr before breakfast

- Monitor thyroid function

44
Q

Liver function tests (nursing imp)

A
  • Encourage proper diet

- Encourage vaccination as appropriate

45
Q

Hepatitis Labs (nursing imp)

A
  • Encourage prevention of transmission

- Eliminate alcohol ingestion