Diabetes

Question 1

Intravenous Dextrose 50% in Water (D50W)

class
MOA
route
onset
AEs

Answer 1

• Class: Glucose-Elevating Agents
• MOA: incr circulating blood glucose
• Route: IV push over 2-5mins
• Onset: mins
• AEs: hyperglycemia, electrolyte disturbances, hyperosmolarity, localized phlebitis, localized tissue necrosis - must use patent IV

Question 2

Nursing Considerations - D50W

Answer 2

• Admin IV (need patent IV) for severe hypoglycemia (per protocol)
• Give supplemental carbohydrate when pt able to swallow to replenish depleted glycogen stores
• Monitor: VS, LOC, BG (rebound hypoglycemia)

Question 3

Glucagon

class
MOA
route
onset
AEs

Answer 3

• Class: Glucose-Elevating Agent
• MOA: accelerates breakdown of glycogen to glucose in liver, causing an incr in BG lvls
• Route: IM or SQ
• Onset: 1 min; peak: 15min; duration: 9-20min
• AEs: hyperglycemia, reboud hypoglycemia

Question 4

Nursing Considerations - Glucagon

Answer 4

• Admin SQ/IM if no IV access for severe hypoglycemia (per protocol)
• Give supplemental carbohydrate to replenish depleted glycogen stores
• Monitor: VS, LOC, BG (rebound hypoglycemia)

Question 5

Hypoglycemia (Causes & CMs)

Answer 5

• Causes:
  > too much insulin or other antidiabetic
  > too little food
  > excess physical exercise
• CMs:
  > cool, clammy skin, tremors, headache, hunger, irritability, change in LOC
  > progression: hypotension, tachycardia, fainting, seizures, coma, death