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Semester Two - Nursing 112 > Diabetes3 > Flashcards

Diabetes3 Flashcards

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1
Q

What is the diabetic patient often treated with?

A
  • Diet
  • Medications, oral hypoglycemia agents or insulin
  • Exercise
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2
Q

Hypoglycemia blood sugar level

A

50-60mg/dL

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3
Q

Signs and Symptoms of hypoglycemia

A
  • Diaphoresis
  • Pale color
  • Feeling of weakness and anxiety
  • irritability or confusion
  • hunger
  • tingling of mouth or fingers
  • tachycardia
  • shakiness
  • palpatations
  • nervousness
  • anxiety
  • headache
  • visual disturbance
  • stupor
  • confusion
  • coma
  • if continues patient may lose consciousness or have a seizure
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4
Q

Causes of hypoglycemia

A
  • Too much insulin
  • Too little food
  • Too much exercise
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5
Q

Emergency treatment of unconscous hypoglycemic patient

A

ABC, IV Dextrose, D50

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6
Q

Treatment of a conscious hypoglycemia patient

A

Fast acting CHO (fruit juice, candy, cake icing, glucose tablets)

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7
Q

How often can you repeat fast acting CHO?

A

every 15 minutes until symptoms resolve

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8
Q

Hypoglycemia blood glucose value

A

<60mg/dL

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9
Q

1 CHO = how many gms of carbs?

A

15 gms carbohydrates

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10
Q

What should you acheive to prevent the risk of cardiovascular disease?

A

lipid profiles and BP levels

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11
Q

What is the appearance of insulin lispro/insulin aspart?

A

clear

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12
Q

What is the route of administration for insulin lispro/insulin aspart?

A

SC

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13
Q

What is the appearance of regular insulin?

A

clear

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14
Q

What is the appearance of NPH insulin?

A

cloudy

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15
Q

What is the appearance of insulin glargine?

A

clear

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16
Q

What is the route of administration for regular insulin?

A

SC or IV

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17
Q

What is the route of administration for NPH insulin?

A

SC

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18
Q

What is the route of administration for insulin glargine?

A

SC

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19
Q

What type of insulin is insulin lispro/insulin aspart?

A

rapid acting

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20
Q

What type of insulin is regular insulin?

A

short acting

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21
Q

What type of insulin is NPH insulin?

A

intermediate acting

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22
Q

What type of insulin is insulin glargine?

A

long acting

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23
Q

What is the onset for insulin lispro/insulin aspart?

A

15-20 minutes

24
Q

What is the onset for regular insulin?

A

30-60 minutes

25
Q

What is the onset for NPH insulin?

A

2 hours

26
Q

What is the onset for insulin glargine?

A

1-2 hours

27
Q

What is the peak of action for insulin lispro/insulin aspart?

A

60-90 minutes

28
Q

What is the peak of action for regular insulin?

A

2-3 hours

29
Q

What is the peak of action for NPH insulin?

A

4-10 hours

30
Q

What is the peak of action for insulin glargine?

A

no sig. peak

31
Q

What is the duration of insulin lispro/insulin aspart?

A

3-4 hours?

32
Q

What is the duration of action for regular insulin?

A

3-6 hours

33
Q

What is the duration of action for NPH insulin?

A

10-16 hours

34
Q

What is the duration of action for insulin glargine?

A

24 hours

35
Q

When should you assess for hypoglycemia after administering insulin lispro/insulin aspart?

A

3 hours after administration

36
Q

When should insulin lispro/insulin aspart be administered?

A

with a meal, 15 minutes before a meal, or stat after a meal

37
Q

When should regular insulin be administered?

A

30-45 minutes before a meal

38
Q

When should NPH insulin be administered?

A

30 minutes before the first meal of the day. requires late afternoon snack so you administer the drug in the same general area bu trotate site for consistency with absorption rates. may be given 30 minutes before supper or bed time.

39
Q

When should insulin glargine be administered?

A

at bedtime

40
Q

lipodystrophy

A

hypertrophy and atrophy casing lumps and dents in skin from repeated injections and which negatively influence absorption

41
Q

Insulin pump

A

insertion sites changed every 2-3 days, requires close blood glucose monitoring, delivers a predetermined amount of short acting insulin at a continuous rate SC

42
Q

Diabetic medications that work on the liver

A

biguanides, insulin

43
Q

diabetic medications that work on the muscle and fat cells

A

insulin, thiazolidinediones

44
Q

diabetic medications that work on the pancreas

A

DPP-4 inhibitors, glinides, some injectable hormones, sulfonyleureas

45
Q

diabetic medications that work on the intestine

A

alpha-glucosidase inhibitors, some injectable hormones

46
Q

Action of sulfonylureas

A
  • stimulates release of insulin from pancreas
  • may improve insulin binding to insulin receptors
  • may increase number of insulin receptors with prolonged use
  • may reduce basal hepatic glucose secroneti
47
Q

Adverse effects sulfonylureas

A
  • hypoglycemia espeically in older patients
  • allergic reactions
  • photosensitivity
  • anemia
  • weight gain
48
Q

Nursing considerations sulfonylureas

A
  • can’t use in patients with sulfa allergies
  • concurrent use of certain medication can increase or decrease effectiveness
  • administer with breakfast
  • may be used as a first line with non-obese or mild obesity
  • long term failure in 30-50% of patients
49
Q

Action biguanide

A
  • inhibits hepatic glucose production
  • increases tissue sensitivity to insulin
  • improves transportation of glucose to cells
  • does not stimulate insulin secretion (lowers FBG)
50
Q

Adverse effects biguanide

A
  • N/V/D
  • headache
  • weakness
  • dizziness
  • drowsiness
    *
51
Q

Nursing consideratons biguanide

A
  • held 48 hours before surgery or use of IV dye due to its potential effects on the kidneys
  • assess renal function prior to starting and annually
  • administer with meals to decrease GI upset
52
Q

Action of dipeptidyl-peptidase-4 inhibitor

A
  • slows the inactivation of incretin hormones
  • lowers glucagon secretion
  • slows gastric emptying
53
Q

Adverse effects dipeptidyl-peptidase-4 inhibitor

A
  • hypoglycemia
  • N/D/V
  • pancreaitis
  • headache
  • anaphylaxis
  • stevens johnsons sydrome
  • angiodema
54
Q

Nursing considerations dipeptidyl-peptidase-4 inhibitor

A
  • may be taken with or without food
  • assess for adverse reactions
55
Q
A

Semester Two - Nursing 112 (90 decks)

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