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NURS 305 - Exam 2 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What types of tissue are contained in the pancreas? (2)

A
  • Exocrine
  • Endocrine
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2
Q

What is the function of exocrine tissue?

A

Production of pancreatic juices

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3
Q

What is the function of endocrine tissue?

A

Production of glucagon / insulin

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4
Q

______ is the primary source of energy for cells

A

Glucose

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5
Q

What does complete lack of insulin lead to? (3)

A
  • Polyuria
  • Polydipsia
  • Polyphagia
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6
Q

What is the route of insulin?

A

SQ

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7
Q

ONLY ______ insulin can be given IV

A

Regular

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8
Q

It is important to rotate insulin sites to avoid risk of ______

A

Lipodystrophy (degeneration of adipose tissue)

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9
Q

What is the primary side effect of insulin?

A

Hypoglycemia

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10
Q

What factors of insulin are important to know? (3)

A
  • Onset
  • Peak
  • Duration
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11
Q

Risk of hypoglycemia is highest during the ______ of insulin action

A

Peak

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12
Q

Which type of insulin has the following?

Onset: 15 - 30 minutes

Peak: 1 - 2 hours

Duration: 3 - 5 hours

A

Rapid

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13
Q

Which type of insulin has the following?

Onset: 30 - 60 minutes

Peak: 1 - 5 hours

Duration: 6 - 10 hours

A

Short (regular)

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14
Q

Which type of insulin has the following?

Onset: 1 - 2 hours

Peak: 6 - 14 hours

Duration: 10 - 18 hours

A

Intermediate

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15
Q

Which type of insulin has the following?

Onset: 1 - 2 hours

Peak: none

Duration: 24 hours

A

Long

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16
Q

Meal time insulin is also known as ______ insulin

A

Bolus

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17
Q

Administer rapid insulin within ______ minutes prior to meal

A

15

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18
Q

Administer rapid insulin within ______ minutes after start of meal

A

20

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19
Q

What are some examples of rapid insulin? (3)

A
  • Aspart
  • Lispro
  • Glulisine
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20
Q

What are the agents of short-acting insulin (regular)?

A
  • Humulin R
  • Novolin R
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21
Q

Administer rapid insulin within ______ minutes prior to meal

A

30

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22
Q

Humulin R is available in ______ (concentrated insulin)

A

U-500 (500 units / mL)

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23
Q

What are the agents of intermediate (NPH) insulin?

A
  • Humulin N
  • Novolin N
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24
Q

Intermediate (NPH) is ______ insulin

A

Basal

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25
Q

When is intermediate (NPH) insulin administered?

A

Morning and evening

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26
Q

Describe the appearance of intermediate (NPH) insulin

A

Cloudy appearance - roll before administration

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27
Q

Administer mixed insulin within ______ minutes prior to meal

A

30

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28
Q

What are the agents of mixed insulin? (3)

A
  • Humulin
  • Novolin
  • Novolog
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29
Q

Which type of insulin is 70% intermediate, 30% short?

A

Humulin

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30
Q

Which type of insulin in 70% long, 30% short?

A

Novolin

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31
Q

Which type of insulin is 70% long, 30% rapid?

A

Novolog

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32
Q

Never mix ______ insulins

A

Basal

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33
Q

Describe the steps of mixing insulin

A

** Draw up the clear (fast-acting) before the cloudy (long-acting)

  • Inject air into cloudy
  • Inject air into clear
  • Withdraw clear
  • Withdraw cloudy
34
Q

Lantus insulin is ______

A

Long-acting

35
Q

Lantus insulin requires ______ daily dosing

A

Once

36
Q

Levemir insulin is ______

A

Long-acting

37
Q

Levemir insulin requires ______ daily dosing

A

Twice

38
Q

Levemir is ______

A

Weight-based

39
Q

Levemir is a ______ insulin

A

Basal

40
Q

Subcutaneous short-acting or regular insulin doses are adjusted according to ______

A

Blood glucose test results

41
Q

When is the sliding-scale (correction factor) used in insulin dosing?

A

TPN / enteral tube feedings

42
Q

Subcutaneous insulin is ordered in an amount that increases as ______ increases

A

Blood glucose

43
Q

Describe the disadvantages of sliding-scale (correction factor) insulin dosing (2)

A
  • Delays insulin until onset of hyperglycemia
  • Swings in glucose control
44
Q

Describe the 2 coverages of insulin

A
  • Basal coverage - 24 hour need
  • Food coverage - 2 hour need / meal
45
Q

______ medications are most frequently used for recently diagnosed type II diabetics

A

Oral

46
Q

Name an example of a biguanide (glucophage)

A

Metformin

47
Q

Describe the mechanism of action of biguanides (glucophages) (2)

A
  • Decrease glucose release
  • Increase insulin sensitivity
48
Q

Glucophage does not cause ______

A

Hypoglycemia

49
Q

Describe the nursing considerations of biguanides (glucophages) (2)

A
  • Hold 48 hours before / after IV contrast
  • Monitor renal function
50
Q

What are the indications of biguanides (glucophages)? (2)

A
  • Pre-diabetes
  • Polycystic ovarian disease
51
Q

Biguanides (glucophages) are used for those with BMI of ______

A

> 25% (weight loss effect)

52
Q

What is the primary side effect of biguanides (glucophages)?

A

Lactic acidosis

53
Q

Name an example of a sulfonylurea

A

Glucotrol

54
Q

Describe the mechanism of action of sulfonylureas (2)

A
  • Decrease insulin resistance
  • Increase insulin secretion
55
Q

What is the primary indication of glucotrol?

A

Poor renal function

56
Q

What are the side effects of sulfonylureas? (2)

A
  • Hypoglycemia
  • Weight gain
57
Q

Describe the mechanism of action of alpha-glucoside inhibitors

A

Delay absorption of glucose

58
Q

Why must alpha-glucoside inhibitors be taken with meals?

A

Prevention of postprandial blood glucose elevations

59
Q

Name an example of an alpha-glucoside inhibitor

A

Precose

60
Q

What are the side effects of alpha-glucoside inhibitors? (3)

A
  • Flatulence
  • Diarrhea
  • Abdominal pain
61
Q

Describe the mechanism of action of dipeptidyl peptidase IV (DPP-IV) inhibitors

A

Delay breakdown of incretin

62
Q

What are the functions of incretin? (2)

A
  • Increases insulin synthesis
  • Decreases glucagon breakdown
63
Q

Dipeptidyl peptidase IV (DPP-IV) inhibitors should NOT be used with ______

A

Insulin

64
Q

Describe the mechanism of action of SGLT-2 inhibitors

A

Inhibits reabsorption of filtered glucose –> promotes excretion of glucose into urine

65
Q

Name an example of a SGLT-2 inhibitor

A

Invokana

66
Q

Describe the dosing of SGLT-2 inhibitors

A

Once a day in the morning

67
Q

What are the side effects of SGLT-2 inhibitors? (2)

A
  • UTIs
  • Vaginal infections
68
Q

What is the primary adverse side effect of thiazolidinediones (TZDs)?

A

Congestive heart failure due to fluid retention

69
Q

DO NOT use ______ with heart failure patients

A

Thiazolidinediones (TZDs)

70
Q

Administer meglitinides within ______ minutes prior to meal

A

15 - 30

71
Q

Describe the mechanism of action of GLP-1 agonists (3)

A
  • Suppress elevated glucagon
  • Slow gastric emptying
  • Decrease appetite
72
Q

Name some examples of GLP-1 agonists (3)

A
  • Byetta
  • Ozempic
  • Victoza
73
Q

Byetta and victoza should be administered ______ hours apart from oral meds

A

1 - 2

74
Q

______ is a natural hormone released by the beta cells in response to food and reduces postprandial blood glucose

A

Amylin

75
Q

Describe the mechanism of action of amylin agonists (2)

A
  • Slows gastric emptying
  • Suppresses glucagon
76
Q

______ in patients with diabetes is 8 times higher than in general population

A

MI

77
Q

Name 2 examples of medications used to reduce cardiovascular death in diabetics

A
  • Jardiance
  • Liraglutide
78
Q

Check ______ before giving insulin

A

Blood glucose level

79
Q

Describe the storage of insulin pens / vials (2)

A
  • Unopened insulin pens or vials should be kept in the refrigerator
  • Open vials or pens may be kept at room temperature for 28 days
80
Q

What is the first rule of treating diabetes?

A

Minimize hypoglycemic events

81
Q

Describe the rule of 15s

A
  • Give patient 15 grams of quick-acting carbohydrates
  • Wait 15 minutes and test blood glucose
  • If unable to test, treat every 15 min until symptoms resolve

NURS 305 - Exam 2 (4 decks)

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