Exam five chapter 50

Question 1

What are the types of insulin?

Answer 1

rapid, short, intermediate, long

Question 2

What are the rapid types of insulim

Answer 2

lispro, aspart, glulisine

Question 3

What is the onset, duration, and peak of rapid acting insulin

Answer 3

onset 15-30 minutes ; duration 3-6 hrs ; peak 30 min-2.5 hrs

Question 4

What are the short acting insulins?

Answer 4

regular

Question 5

What is the onset, peak, and duration of short acting insulin

Answer 5

onset 30-60 min ; peak 1-5 hrs; duration 6-10 hrs

Question 6

What is the intermediate acting insulin

Answer 6

NPH

Question 7

What is the onset, peak, and duration of intermediate acting insulin

Answer 7

onset 1-2hrs ; peak 6-14 hrs ; duration 16-24 hrs

Question 8

What is the long acting insulin

Answer 8

insulin glargine and determir

Question 9

what is the onset, peak, and duration of long acting insulin

Answer 9

onset 70 min; peak (none) ; duration 18-24 hrs

Question 10

What is combination insulin?

Answer 10

composed short and immediate acting ; rapid and immediate acting

Question 11

If we have combination insulin of 70/30 how much is intermediate and short?

Answer 11

30 short ; 70 intermediate

Question 12

Can you give long insulins via IV

Answer 12

no

Question 13

Can you mix long acting insulins

Answer 13

no

Question 14

What is the action of insulin?

Answer 14

promotes use of glucose by body cells and stores glucose as glycogen in the muscle cells… this reduces amount of glucose in the blood

Question 15

How is insulin used in type 1, 2, and gestational diabetes

Answer 15

used for glycemic control

Question 16

Those with type 2 diabetes should implement what?

Answer 16

lifestyle modifications

Question 17

Initial treatment of those with type 2 diabetes is

Answer 17

oral anti-diabetic medications

Question 18

Those with type 2 DM may require insulin when?

Answer 18

oral anti-diabetic medications do not work, renal and liver disease, trauma, stress, illness, DKA, neuropathy, hyperkalemia

Question 19

What insulins can be given via IV

Answer 19

rapid and short

Question 20

If patient is awake and has hypoglycemia, we can give them?

Answer 20

oral glucose

Question 21

If our patient is unconscious or NPO and have hypoglycemia, we give them?

Answer 21

iv glucose, subcut glucagon

Question 22

Complications of insulin?

Answer 22

hypoglycemia, lipohypertrophy, hypokalemia, hyperglycemia

Question 23

What are symptoms of hypoglycemia?

Answer 23

headache, sweating, nervousness, hunger, tremors, confusion, weakness

Question 24

What is lipohypertrophy?

Answer 24

what can occur if we do not rotate injection sites

Question 25

Symptoms of hyperglycemia?

Answer 25

polyuria, polydipsia, polyphagia, increased blood glucose

Question 26

Patients should keep snacks with many many carbs in case of hypoglycemia?

Answer 26

15 g (4 oz orange juice and 8 oz milk)

Question 27

How should we teach our patient to do insulin injections?

Answer 27

rotate injection sites within 1 anatomical region

Question 28

If our patient loses unconsciousness at home, we should teach the family to administer?

Answer 28

subcutaneous glucagon

Question 29

We should teach our patient to?

Answer 29

know S/S of hyper and hypoglycemia, wear medic alert bracelet, how to check blood sugar, healthy diets

Question 30

Unopened vials of insulin should be?

Answer 30

refrigerated

Question 31

How long is opened insulin allowed to stay unrefrigerated?

Answer 31

one month

Question 32

how do we mix insulins?

Answer 32

roll in hands, inject air into NPH(cloudy), inject air into clear (regular), draw clear, draw cloudy

Question 33

The sliding scale is only used for

Answer 33

rapid and short acting insulin

Question 34

Is every sliding scale the same

Answer 34

no

Question 35

When do we use the sliding scale

Answer 35

AC/HS (before meals and at bedtime)

Question 36

What drug class is sulfonylureas?

Answer 36

oral hypoglycemic

Question 37

what are the sulfonylureas?

Answer 37

glimepiride, glipizide, glyburide

Question 38

Sulfonylureas are used in what type of diabetic?

Answer 38

type 2

Question 39

How do sulfonylureas work

Answer 39

releasing insulin from the pancreas

Question 40

Adverse effect of sulfonylureas?

Answer 40

hypoglycemia

Question 41

What are the contraindications for sulfonylureas?

Answer 41

treatment of DKA, sulfa allergy, alcohol

Question 42

Patient teaching for sulfonylureas

Answer 42

monitor s/s of hypoglycemia, monitor POC glucose, keep log, take with breakfast, avoid alcohol

Question 43

Examples of 15 g carb snacks

Answer 43

4 oz OJ, 8 oz milk, 2 oz grape, glucose tablets

Question 44

why should those on sulfonylureas avoid alcohol

Answer 44

causes disulfiram like reaction

Question 45

Indications for metformin

Answer 45

control blood glucose levels in type 2 DM

Question 46

How does metformin work?

Answer 46

reduces production of glucose, decreases absorption of glucose, increases insulin sensitivityM

Question 47

What drug class is metformin?

Answer 47

biguanide

Question 48

Patient teaching for metformin??

Answer 48

monitor weight loss, take with meals, take vitamin b12 and folic acid supplements, teach s/s of lactic acidosis and tell them to report

Question 49

What s/s of lactic acidosis should we teach our patients on metformin to report?

Answer 49

hyperventilation, myalgia, sluggishness, nausea, vomiting

Question 50

How long before receiving contrast dye should our patients stop taking metformin

Answer 50

24-48 hrs (do not resume for 48 hrs)

Question 51

should patients over 80 years old take metformin?

Answer 51

no