Exam 6 - Diabetes Flashcards
What is the most reliable measure for assessing diabetes control over the preceding 3-month period? What should it be?
Hemoglobin A1C lab test
should be under 7 (6.5)
What are short term complications of diabetes?
hypoglycemia, hyperglycemia, ketoacidosis
What are long term complications of diabetes?
Macro:
cardiovascular disease (and ATHEROSCLEROSIS)
hypertension
stroke
Micro: damage to small vessels and capillaries
nephropathy, retinopathy, neuropathy - sensory/motor, gastroparesis (stomach doesn’t empty so the gastric cells continue to secrete enzymes and you throw up bile), amputations, erectile dysfunction
What are the three signs of hyperglycemia?
polyuria, polyphagia, polydipsea
Which of all the insulins is NOT clear? What will the nurse do to prepare the med prior to drawing the med into the syringe?
NPH – it is cloudy
roll it, don’t need to shake it
What is tight glycemic control? What is the benefit? What are some considerations?
trying to avoid the fluctuations
they might have a glucose monitor and insulin pump on them
-if they do a good job there is decreased risk of cardiovascular disease and renal complications
considerations:
Which of the following medications has the most rapid onset? which can you use in an IV as an infusion?
A) Humulin
B) Novolin
C) Lispro
Lispro is the most rapid
Regular insulin is the only one you can use in an IV as an infusion
Lispro (Humalog) info.
short acting, short duration
SUbQ administration
may be mixed in the same syringe with NPH
may be used in combination with intermediate and long-acting insulins
Onset: 10-30min // Peak: 30-2.5 hrs // Duration: 3-6hrs
What teaching will the nurse provide to the patient who will begin self administration of Lispro? How long once
-rotate the site
-keep the sites clean (wash your hands)
-store in the fridge to last longer (once opened, can store 3 months in the fridge, and 1 month outside of the fridge)
-avoid direct sunlight and high temperature areas
-prefilled syringes should be kept in the fridge and used within 1-2 weeks
what is the right order of NPH and regular insulin when administering together?
clear before cloudy
what are the signs of hypoglycemi?
shaking, decreased LOC, confusion, diaphoretic, tachycardi
glargine
- what is the best time for the patient to take this?
make sure to administer the same time everyday (b/c it is 24hr acting)
which antibiotic works by decreasing glucose production by the liver and decreases glucose uptake by muscle and adipose tissue?
Biguanide (metformin)
-does not promote insulin release
**fill out this slide more
Which medication will stimulate the release of insulin?
Sulfonylureas (glyburide)
-watch out for hypoglycemia
How can the nurse remember the drugs are sulfonylureas?
Glipizide, Glypburide
Glimepiride
