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Exam 3 Flashcards

1
Q

Hyperglycemia lab values

A

Fasting BS >126 my/dL
Nonfasting BS. >200 my/dL
A1c. . >6.5%
Pre-DM. A1c. 5.7 - 6.5%

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2
Q

Diabetic Ketoacidosis level
DKA

A

Blood glucose. >500mg/dL

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3
Q

Symptoms of Hypoglycemia

A

Irritability
Shaky
+ Pulse
Weakness
Confusion
Tremor
Sweating
Hypothermia
Seizures
Death

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4
Q

Hypoglycemia blood level

A

Blood glucose. <50 my/dL

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5
Q

Treatment for Hypoglycemia

A

Dextrose IV
Glucagon IM, Sub Q
Oral glucose gel or tablets

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6
Q

Types of Rapid Acting Insulin

A

aspart (NovaLog) -clear
lispro (Humlog) -clear
gluslisine (Apidra) -clear

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7
Q

Onset, Peak, Duration Rapid Acting

A

Rapid onset 15 min
Peak 1-2hrs
Shortest duration 3-5hrs
Keep food in the room

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8
Q

Nursing Implications for Rapid Acting Insulin

A

Sub Q
Insulin Pump
5 min before meals
Keep food in room

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9
Q

Types of Short Acting Insulin

A

Regular Insulin (Humulin R, Novolin R) clear

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10
Q

Onset, Duration, Peak for Short Acting Insulin

A

Onset 30-60min (double of rapid)
Peak- 2.5 hrs
Duration 6-10 hrs

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11
Q

Nursing Implications for short acting

A

Sub Q
IV
30 min before meals
Sliding scales
Don’t adjust levels quickly 30-50/hr

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12
Q

Types of Intermediate Acting Insulin

A

insulin isoprene suspension (NPH)
Humulin N
Novolin N
All cloudy

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13
Q

Onset and Peak for Intermediate Acting Insulin

A

Onset 1-2 hrs
Peak of 4-8 hrs

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14
Q

Nursing Implications

A

Sub Q
30-60 min before meals
Often premixed with regular insulin

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15
Q

Types of Long Acting Insulin

A

glargine (Lantus) clear -most common
detemir (Levemir) cloudy
degludec (Tresiba) cloudy

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16
Q

Onset of Long Acting Insulin

A

Onset 1-2 hrs
Give at night to stabilize sugars

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17
Q

Nursing Implications for Long acting insulin

A

Sub Q
Once day dosing at night
Don’t mix injection

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18
Q

Combination Insulin

A

NPH & Regular (Humulin 70/30, Novolin 70/30)

NPH & Regular (Humulin 50/50)

Lispro Protamine & Lispro
(Humalog Mix 75/25) Food in room

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19
Q

Insulin Storage

A

Room Temp for 90 days
Avoid sun & heat
Refrigerator if more than 90 days
Check color (abnl cloudiness)

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20
Q

Define Lipohypertrophy

A

Scar tissue- rotate sites

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21
Q

With the Insulin Pump the needle is changed

A

Needle changed every 3 days

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22
Q

A large amount of what is dangerous in children?

A

Iron

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23
Q

Fat soluble vitamins

A

A, D, E, & K

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24
Q

Water soluble vitamins

25
Hypervitaminosis occurs mostly in what type of vitamins?
Fat soluble (A, D, E, K)
26
Vitamin A
aka retinol Fat soluble Helps adapting to dim light For bone growth and teeth Low Vit A- night blindness, dry skin Toxicity- Can cause birth defects - + risk of hip fx - watch for cirrhosis & hep
27
Vitamin D
Regulates metabolism of calcium & phosphorus Fat soluble Sun exposure Deficiency- Rickets & osteomalacia toddlers bones are soft Toxicity- hypercalcemia, HTN, anorexia
28
Vitamin D levels and dosing
50 ng/mL D2 (ergocalciferol) plant based D3 (calcifedol) animal source
29
Vitamin E
aka Alpha-Tocopherol Fat soluble + risk for bleeding Not indicated for 50yrs + Deficiency- preemies Toxicity- difficult to reach
30
Vitamin K
aka phytonadione Fat soluble For synthesis for PT & other clotting factors Food source- green leafy vegetables Deficiency- + risk of bleeding Infants + risk of intracranial hemorrhage
31
Vitamin K routs
IM - newborns Orally- stabilizes ♥️ plaque IV- careful! Risk for HTN, Dyspnea cardiac arrest Reduces warfarin and Coumadin
32
Water soluble vitamins
B1= Thiamine B2= Riboflavin B3= Niacin B5= Pantothenic Acid B6= Pyridoxine B7= Biotin B9= Folate B12= Cobalamin C= Absorbic Acid
33
Vitamin C
aka ascorbic acid Water soluble Production of collagen, absorption of iron Deficiency- Scurvey, lose teeth, gingivitis, poor wound heeling Adverse- nausea, abd cramps, renal stones
34
metformin
aka Glucophage DM Rx Give during meals If taken with Iodine contrast= renal failure & lowes ox in cells -Stop rx 48hrs before & after procedure
35
glipizide
aka Glucotrol DM rx 30 min before meals In Sulfa family Watch for Jaundice & weight gain
36
repaglinide
aka Prandin DM rx Skip the rx if you skip meal
37
pioglitazone
aka Actos DM RX side effects- edema & weight gain Don't give if they have ♥️ failure, liver, or kidney disease
38
acarbose
aka Precose DM Rx Take with first bite of food
39
procaine
aka Novocain local anesthetic Lasts 2-5 min
40
lidocaine
aka Xylocaine, EMLA local anesthetic 1/2 life of 90 min Can use in combo of epinephrine
41
bupivicaine
aka Marcaine Local anesthetic longest duration of 3-9hrs Epidural for 🤰🏽 Spinal anesthesia —— HA’s
42
benzocaine
aka Oragel local anesthetic Don’t use in infants
43
propofol
aka Diprivan IV general anesthesia Rapid onset decrease agitation Don’t take at home Killed MJ
44
ketamine
aka Ketalar IV general anesthesia Disconnected from environment Hallucinations, dilerium, combative Use diazepam before ketamine Less sx if younger than 15yrs old For induction of anesthesia 🦴
45
Nitrous oxide
Laughing gas Not used as primary anesthetic Doesn’t cause respiratory or cardiac depression -Dental procedures N/V post-op (wash face after)
46
sevoflurane
aka Ultane Inhaled anesthetic Rapid onset For inducing anesthesia Doesn’t leave pt drowsy
47
Liquids that you inhale for anesthesia have what suffix?
-ane
48
What is Malignant hyperthermia
Deadly temperature Genetically linked to anesthetic Muscle rigidity, tachycardia
49
What do you do for malignant hyperthermia
Give Dantrolene to relax muscles Cool IV fluids Cool blanket APAP and IBU will not work
50
Neuromuscular blocking drugs have what suffix?
-onium
51
succinylcholine (Sucks to be you)
aka Anectine For tracheal intubation Relaxes all muscles Careful if family Hx of hyperthermia Antidote- neostigmine
52
Other neuromuscular blocking drug
rocuronium (Rock) code cart For intubation
53
Vitamin B1
aka Thiamine Coenzyme for carb metabolism Deficiency- Beriberi Wernicks encephalopathy For alcoholics- banana bay
54
Vitamin B2
aka rivoflavin For en Tem reactions Deficiency-glossitis, cracked lips
55
Vitamin B3
aka Niacin or Nictinic Acid - can reduce LDL Adverse effects- vasodilation, dizziness, nausea Deficiency- red rash in sun areas
56
Vitamin B6
aka Pyridoxine Peripheral neuritis (tingling) Deficiency- Alcoholics and DM can get a red rash on face, looks like acne
57
Vitamin B9
aka Folic Acid For cell growth, decreases birth defects Deficiency- neural tube defects
58
Vitamin B12
aka cyanocobalamin For carb metabolism and protein synthesis needed to make RBC Deficiency- anemia

Pharm (5 decks)

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