Exam 4 Flashcards
Patient born with diabetes has which type?
Type 1. They have to take EXOGENOUS insulin shots for the rest of their life.
- Fewer than 10 percent of cases are type 1.
Is insulin given in mL or Units?
UNITS
Can metformin cause hypoglycemia?
No
Onset for NPH insulin is?
1-2 hours
When giving insulin, what should you rotate?
The injection sites.
The patient is alert with low blood sugar. What do you give them?
FOOD
The patient’s Vitals are bad and their sugar level is 30. What do you give them?
IV Glucose
What is the only insulin you can administer through an IV?
Regular Insulin ONLY!
What should a diabetic do before exercise?
EAT
Glipizide medication needs to be taken when and how?
Taken with the first bite of the first meal in the morning.
Diabetic patient is unconscious. What do you do?
Roll them to their side.
Regular onset time?
30-60 mins
Glargine
Long acting insulin. Onset 1-2 hours
Aspart
Rapid Acting Onset 15 mins
Hemoglobin a1c measure what?
Measure blood sugar levels over the past 3 months
Pregnant women with gestational diabetes, who can’t take pills will be given
insulin injections
Lispro needs to be given with
FOOD
Respiratory rate dropped below 8 due to opioids. What is given
Naloxone (NARCAN)
Max doses for Tylenol
Max: 3000mg
Liver Problems: 2000mg
Patient reports feeling pins and needles?
Neuropathy pain
What vital sign should you check on a person taking opioids?
Respirations
Children cannot have what medicine for fever?
Aspirin. Give them Tylenol instead.
Before giving medication, do what type of assessment?
A pain assessment.
What is phantom pain?
pain from a body part that is no longer there.
What is referred pain?
pain appearing in another part of the body then where is is originating from.
Common adverse effects of opioids
nausea, vomiting, constipation, pruritus, dizziness, dry mouth, and sedation
Hydromorphone
Dilotin
Demerol
Meperidine
cough medicine
Codeine
10x stronger then morphine
Fentanyl
Signs and Symptoms of diabetes
Elevated fasting blood glucose (higher than 126 mg/dL) or a hemoglobin A1C (HbA1C) level greater than or equal to 6.5%
Polyuria
Polydipsia
Polyphagia
Glycosuria
Unexplained weight loss
Fatigue
Blurred vision
Type 2 diabetes Treatments
-Lifestyle changes
-Oral drug therapy
-Insulin when the above no longer provide glycemic control
Fixed Combination Insulin
Contain NPH and either one rapid-acting type (Lispo, Aspart) or one short-acting type (Regular)
How to draw up Insulin
Remember R (Regular or Rapid) before N (NPH/intermediate)
When administering insulin, what should you check?
Check the patients GLUCOSE LEVELS before giving them insulin
Can you shake or roll insulin vials
Roll Vials
Insulin storage
Open unrefrigerated vials, must be discarded after one month
Oral Antidiabetic Drugs
- Used for type 2 Diabetes.
- Effective treatment involves several elements
+Careful monitoring of blood glucose levels
+Therapy with one or more drugs
+Treatment of associated comorbid conditions such as high cholesterol and high blood pressure
If oral antidiabetic drugs are ineffective, what will happen
Insulin will be ordered
Give patient oral antidiabetic drugs 30 mins before what?
Meals
Alpha-glucosidase inhibitors are given
with the first bite of each main meal
Metformin is taken with meals to reduce what?
GI effects
Metformin will need to be discontinued if the patient is
to undergo studies with contrast dye because of possible renal effects; check with the prescriber.
Hypoglycemia
Low blood sugar (below 50mg/dL)
Symptoms of Hypoglycemia
Early: Confusion, irritability, tremor, sweating
Late: Hypothermia, seizures
Coma and death will occur if not treated
Types of Glucose elevating drugs
- Oral forms of concentrated glucose : Buccal tablets, semisolid gel
- 50% dextrose in water (D50W): Given IV
- Glucagon: IV and Subcutaneous forms available
