Endocrine Part 1-Diabetes- INSULIN.ppt Flashcards
Which is Rapid Acting
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)
Which is Regular Acting
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
e. Regular insulin (Humulin R®/Novolin R®)
Which is Intermediate Acting
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
g. Neutral Protamine Hagedorn (NPH)
Which is Long Acting
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
Which hormones play an important part in the Pancreas?
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
b. Insulin
e. Glucagon
Which is stored insulin
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
e. Glucagon
Excess glucose stored in liver and skeletal muscle tissue?
a. Glycogenolysis
b. Glycogen
b. Glycogen
Conversion of glycogen into glucose when needed?
a. Glycogenolysis
b. Glycogen
a. Glycogenolysis
Which is release when you eat food?
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
b. Insulin
Which is released when your starving?
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
e. Glucagon
Insulin does which of the following
a. Direct effect on fat metabolism
b. Stimulates lipogenesis and inhibits lipolysis
c. Stimulates protein synthesis
d. None
All
Which promotes intracellular shift of potassium (Hyperkalemia) and magnesium into the cells
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
b. Insulin
Which is an autoinmmune disorder with insulin (dependent)
a. Type 1
b. Type 2
a. Type 1
Which is resistance to insulin (Highrer dose)
a. Type 1
b. Type 2
b. Type 2
Which means production of abnormally large volumes of dilute urine?
a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)
b. Polyuria
Which is abnormally great thirst as a symptom of disease (such as diabetes) or psychological disturbance?
a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)
a. Polydipsia
Which is the medical term for excessive or extreme hunge?
a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)
d. Polyphagia (hyperphagia)
Which is a rare condition in which the simple sugar glucose is eliminated (excreted) in the urine despite normal or low blood glucose levels.
a. Polydipsia
b. Polyuria
c. Glycosuria
d. Polyphagia (hyperphagia)
c. Glycosuria
Diabetes Mellitus
Elevated fasting blood glucose (higher than ? mg/dL) or a hemoglobin A1C (HbA1C) level greater than or equal to ? %
126
6.5
Which are symptoms of Diabetes Mellitus?
a. Polyuria,
b. Polydipsia,
c. Polyphagia
d. Glycosuria
e. Unexplained weight gain
f. Unexplained weight loss
g. Fatigue
h. Blurred vision
a. Polyuria,
b. Polydipsia,
c. Polyphagia
d. Glycosuria
f. Unexplained weight loss
g. Fatigue
h. Blurred vision
A patient with Diabetes Mellitus what is the HbA1C must be?
Less than 7
The Fasting blood glucose ? to ? mg/dL is the goal for diabetic patients.
70
130
Fill in the blank
? = Normal
? = Prediabetes
? = Type 2 diabetes
<5.7
5.7 to 6.4
>6.5
Fasting blood glucose 70 mg/dL is ( hyperglycemia or hypoglycemia) and should you give insulin ? Y/N
hypoglycemia
No
Which type of Diabetes Mellitus: Lifestyle changes ORAL drug therapy Insulin when the above no longer provide glycemic control a. Type 1 b. Tyoe 2
b. Tyoe 2
Which type of Diabetes Mellitus:
Insulin therapy
a. Type 1
b. Tyoe 2
a. Type 1
Insulin treats?
a. hyperglycemia
b. hypoglycemia
c. Type I
d. Type II
e. Hypokalemia
f. Hyperkalemia
a. hyperglycemia
c. Type I
d. Type II
f. Hyperkalemia
Insulin move what into our cells?
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
f. Pottasium
e. Glucagon
f. Pottasium
Which shows the onset, peak, and duration of insulin?
a. Background Insulin replacement
b. Bolus Insulin Replacement
c. Natural Insulin Secretion
b. Bolus Insulin Replacement
Which insulin would you give a patient after they eat?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
FAST & REGULAR
Rapid‑acting: Lispro insulin
◦ONSET: ? to ? min
◦PEAK: ? to ? hr
◦DURATION: ? to ? hr
◦ONSET: 15 to 30 min
◦PEAK: 0.5 to 2.5 hr
◦DURATION: 3 to 6 hr
Short‑acting: Regular insulin
◦ONSET: ? to ? hr
◦PEAK: ? to ? hr
◦DURATION: ? to ? hr
◦ONSET: 0.5 to 1 hr
◦PEAK: 1 to 5 hr
◦DURATION: 6 to 10 hr
Intermediate‑acting: NPH insulin
•ONSET: ? to ? hr
•PEAK: ? to ? hr
•DURATION: ? to ? hr
- ONSET: 1 to 2 hr
- PEAK: 6 to 14 hr
- DURATION: 16 to 24 hr
Long‑acting: Insulin glargine
•ONSET: ? min
•PEAK:
•DURATION: ? to ? hr
- ONSET: 70 min
- PEAK: None
- DURATION: 18 to 24 hr
Which insulin does not have a peak?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
Which is true about administering insulin
a. Hyperglycemia is defined as <70 mg/dL
b. Consider holding if <130
c. Consider holding dose if patient not eating
d. Give dose if patient not eating
b. Consider holding if <130
c. Consider holding dose if patient not eating
Which lab level should you check when patients are on insulin IV Drip?
a. Estrogen
b. Insulin
c. Progesterone
d. Prolactin
e. Glucagon
f. Pottasium
f. Pottasium
Which Hemoglobin A1C 3monthaverage of glucose levels.
Would you use the average to administer insulin?
Y/N
No - do a need glucose screening!
Which is insulin given 95 percent of the time?
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
d. SQ
Which is insulin not given?
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
b. Oral
Which come in a form of injections or pumps?
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
d. SQ
Which is is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones?
a. Diabetic ketoacidosis (DKA)
b. Hyperglycemic hyperosmolar syndrome (HHS)
b. Hyperglycemic hyperosmolar syndrome (HHS)
Which is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin?
a. Diabetic ketoacidosis (DKA)
b. Hyperglycemic hyperosmolar syndrome (HHS)
a. Diabetic ketoacidosis (DKA)
Which is given as a continuous infusion for HHS/DKA patients?
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
c. IV
e. Rapid Insulin
f. Regular Insulin
Which is given to push to treat hyperkalemia or critically high glucose?
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
c. IV
e. Rapid Insulin
Which is given for for emergency purposes
a. Inhaled
b. Oral
c. IV
d. SQ
e. Rapid Insulin
f. Regular Insulin
c. IV
Which is a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin?
a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain
b. Lipo-hypertrophy
Which Insulins hav this adverse side effect? Hypoglycemia Lipo-hypertrophy Hypokalemia Weight gain a. Insulin lispro (Humalog®) b. Insulin detemir (Levemir®) c. Aspart (Novolog®), d. Insulin (Humulin N®) e. Regular insulin (Humulin R®/Novolin R®) f. Glulisine (Apidra®) g. Neutral Protamine Hagedorn (NPH) h. Insulin glargine (Lantus®)
All
Which all insulin not Rotate injection sites weekly could cause?
a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain
b. Lipo-hypertrophy
With all insulins should educate your patients about
a. hypoglycemia
b. hyperglycemia
a. hypoglycemia
Which all insulins the hypoglycemia is a risk during?
a. Onset
b. Peak
c. Duration
b. Peak
Which treats diabetes?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
All
Which treats DKA/HHS & Hyperkalemia Emergencies
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
e. Regular insulin (Humulin R®/Novolin R®)
Is it true that all insulins can be given by SQ? Y/N
If yes, which ones are only given with IV+SQ?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
Yes
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
All insulins are clear except? and why?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
g. Neutral Protamine Hagedorn (NPH)/ Intermediate
because it is cloudy!
Which insulin is cloudy?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
g. Neutral Protamine Hagedorn (NPH)/ Intermediate
because it is cloudy!
Which is Administer 15 minutes before a meal or with the meal
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)
Which Administer 30 minutes before a meal
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
e. Regular insulin (Humulin R®/Novolin R®)
g. Neutral Protamine Hagedorn (NPH)
Which does not matter with or without food
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
Which is given once a day
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
What is true about SQ?
a. Small needle
b. Large needle
c. 23 to 25 gauge
d. 28 to 31 gauge
e. Shorter length
f. Larger length
g. Site: Arms, Thighs, Abdomen
g. Site: Deltoid, Thighs, Abdomen
a. Small needle
d. 28 to 31 gauge
e. Shorter length
g. Site: Arms, Thighs, Abdomen
Cold insulin can cause ?
a. Hypoglycemia
b. Lipo-hypertrophy
c. Hypokalemia
d. Weight gain
b. Lipo-hypertrophy
To avoid Lipo-hypertrophy
a. rotate sites ?
b. Each day, rotate around ? from previous site,
c. then go to new site after ? week
Weekly
½-1 inch
1
Should you hold insulin if patient is having nausea or vomiting. Y/N
Yes
If a patient is NPO before a procedure shoudl you check with provider before admistering insulin? Y/N
Yes
Which is early signs of Hypoglycemia
a. Irritability
b. Sweating
c. SNS activation
d. Hypothermia,
e. tremor,
f. seizures
g. Coma and death will occur if not treated
h. Confusion
a. Irritability
b. Sweating
c. SNS activation
e. tremor,
h. Confusion
Which are late signs of Hypoglycemia
a. Irritability
b. Sweating
c. SNS activation
d. Hypothermia,
e. tremor,
f. seizures
g. Coma and death will occur if not treated
h. Confusion
d. Hypothermia,
f. seizures
g. Coma and death will occur if not treated
Should you always check Glucose levels first with Hypoglycemia. Y/N
Yes
Hypoglycemia
a. Give ? grams of carbohydrates
b. Hospitals will always have ?
c. If at home, can do ? ounces of orange juice, ? oz of grape juice
15
glucose tablets
4
2
What do you give If patient has altered mental status?
a. IV Normal Saline
b. IV glucose (DEXTROSE)
c. SQ Insulin
d. IM Glucagon
b. IV glucose (DEXTROSE)
d. IM Glucagon
If a patient is Hypoglycemia should they?
a. Not eat food
b. Eat food
b. Eat food
Which causes higher risk for HYPO event with Insulin?
a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med
e. Other diabetes med
What can mask S/S of hypoglycemia + suppress the liver with insulin?
a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med
a. Beta blockers
Which is known to cause HYPERglycemia with insulin?
a. Beta blockers
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
e. Other diabetes med
b. Diuretics
c. HCTZ (hydrochlorothiazide)
d. Steroids
Which is true about cloudy insulins?
a. You can use all insulins that appear cloudy
b. Neutral Protamine Hagedorn (NPH) (Intermediate) is the only insulin that cloudy.
c. Acceptable insulins mixed with Neutral Protamine Hagedorn can be cloudy.
d. Insulins besides NPH that appear cloudy are infused with bacteria.
b. Neutral Protamine Hagedorn (NPH) (Intermediate) is the only insulin that cloudy.
c. Acceptable insulins mixed with Neutral Protamine Hagedorn can be cloudy.
d. Insulins besides NPH that appear cloudy are infused with bacteria.
What are the acceptable insulins that can be mixed with NPH SEPERATELY?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
Rapid and Short
Which can not be mixed with NPH
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
b. Insulin detemir (Levemir®)
h. Insulin glargine (Lantus®)
Long acting
Which is true when you mix other insulins with NPH
a. Cloudy to Clear
b. Clear to Cloudy
b. Clear to Cloudy
Put in order!
a. Put 10 units of air in Rapid Insulin
b. Put 10 units of air in NPH
c. Pull 10 units od NPH
d. Pull 10 units of Rapid Insulin
b. Put 10 units of air in NPH
a. Put 10 units of air in Rapid Insulin
d. Pull 10 units of Rapid Insulin
c. Pull 10 units od NPH
In order to mix the suspension?
a. Shake the vials
b. Roll the vials
b. Roll the vials
Which drugs can you shake?
a. Parental
b. Oral
b. Oral
What do the ratios Mean? What does the bigger number mean? Humulin 70/30 Novolin 70/30 Humalog 75/25 NovoLog 70/30
The number insulin inside.
The longer it takes for the insulin work through the body.
Insulin
UNOPENED
a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
c. In general, keep insulin in refrigerator
d. Must discard after 28 days
e. Use normal expiration date on vial
f. Keep at Room Temp to avoid Lipo-hypertrophy
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth
c. In general, keep insulin in refrigerator
e. Use normal expiration date on vial
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth
Insulin
OPENED
a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
c. In general, keep insulin in refrigerator
d. Must discard after 28 days
e. Use normal expiration date on vial
f. Keep at Room Temp to avoid Lipo-hypertrophy
g. Keeping it refrigerated makes it last longer and prevents any bacterial growth
a. Keep at room temp to avoid cold injection in your abdomen.
b. Can keep at room temperature
d. Must discard after 28 days
f. Keep at Room Temp to avoid Lipo-hypertrophy
Which isa Preferred method of treatment for hospitalized patients with DM
a. Basal insulin
b. Bolus insulin
c. None
a. Basal insulin
b. Bolus insulin
? insulin is a long-acting insulin (insulin glargine)
a. Basal insulin
b. Bolus insulin
c. None
a. Basal insulin
? insulin (insulin lispro or insulin aspart)
a. Basal insulin
b. Bolus insulin
c. None
b. Bolus insulin
What type of insulin would you use for in an Insulin Pump?
a. Insulin lispro (Humalog®)
b. Insulin detemir (Levemir®)
c. Aspart (Novolog®),
d. Insulin (Humulin N®)
e. Regular insulin (Humulin R®/Novolin R®)
f. Glulisine (Apidra®)
g. Neutral Protamine Hagedorn (NPH)
h. Insulin glargine (Lantus®)
a. Insulin lispro (Humalog®)
c. Aspart (Novolog®),
f. Glulisine (Apidra®)