Diabetes Flashcards
What is insulin and what does it do?
What is a basal rate and what is a bolus?
Basal: small amount all the time
Bolus: large amount (with meals)
Fast release of glucose:
Glucagon: from alpha cells of pancreas
Epinephrine: from medulla of adrenal glands
Slow release of glucose:
Cortisol: from cortex of adrenal glands
Growth hormone: from anterior pituitary gland
Insulin: rapid acting
Lispro: what is the onset, peak, duration and route of this medication?
What are med specific indications?
Onset: 15min
Peak: 60min
Duration: 4 hours
Route: SQ pump
*risk low BG: peak action 3 times daily with meals
What are nursing indications for rapid acting insulin?
— always check glucose prior to giving insulin; prior to eating
— administer medication 0-15 minutes prior to start of meal
— verify orders; every diabetic has different orders
— rotate injection sites
*HOLD PARAMETERS; HIGH ALERT MEDICATION
Consider NPO status
Short acting insulin: regular
What is the onset, peak, duration, and the route?
What are med specific indications?
Onset: 60min
Peak: 2-3 hr
Duration: 6-10 hr
Route: SQ (risk low BG: peak actions
IV drip (hourly per protocol)
Long acting insulin:
Glargine: what is the onset, peak, duration and route?
Med specific indications?
Onset: gradual
Peak: none
Duration: 24hr
Route: SQ
*lower risk for low BG; used 1-2 times daily
Compare and contrast the different types of insulin delivery devices:
Insulin by syringe:
— most common
— inexpensive
— multi-dose vial; one time use
Insulin by pen:
— pre-filled
— expensive; not many people want to pay
— multi-dose; disinfect with alcohol
Insulin pump
Infusion set insertion device:
— cannula in SQ tissue
— pre-filled with insulin
— expensive; not many people have
risk for infection at insertion site
Insulin reservoir/pump:
— slow insulin release + bolus
*frequent BG monitoring
— continuous glucose monitoring communicates with pump
What are indications of continuous IV insulin drip?
— DKA
— HHS
— critical care
— peri-operative period
— NPO type 1 DM
— L+D
— TPN
— glucose exacerbated by high dose glucocorticoid therapy
*peripheral or central line
—BG checked hourly
What is metformin and what does it do?
*only oral drug approved for age 10+
What is glipizide and what does it do?
What is ADPIE?
Assessment
Diagnosis
Planning
Implementation
Evaluation
What do you need to asses with diabetic clients?
— physical assessment
— BG prior to administration of any insulin
— review/monitor labs to make sure the kidneys still work
*diabetes can lead to AKI; kidney disease
What is a nursing diagnosis for diabetes?
— risk for unstable blood glucose
— imbalanced nutrition
— disturbed sensory perception
— risk for infection
What are some expected outcomes for diabetes?
— therapeutic affect: control of BG levels, stable HGB and A1C
— limited complications
— limited AE; avoiding hypoglycemia
— adequate understanding of disease
— medication management
What are some nursing interventions/education for diabetes?
— BG control
— timing of insulin; rotate injection sites (SQ)
— store unopened insulin vials in cool, dry place (fridge)
— lifestyle modification
— signs and symptoms of hypoglycemia and how to treat
*education is really important
What do you evaluate with diabetic clients?
— adequate glucose control
HBG A1C: <8.0; fasting BG: <126
— absence of micro/macrovascular complications
— AE: signs/symptoms of hypoglycemia
— was teaching effective?
— compliance
— cost
What is glucagon?
Onset, peak & duration?
onset: 1 min
peak: 15 min
duration: 9-20 min
*tx for hypoglycemia
What is D50W?
how long do you push this medication?
IV push over 2-5 minutes
The UAP notifies the nurse a diabetics BG is 53, what assessment should the nurse perform?
A. HR
B. Skin temp.
C. LOC
D. Urine output
C. LOC
Hypoglycemic
