Insulin delivery devices and use Flashcards
How are disposable insulin syringes chosen?
According to dose of insulin that needs to be injected
0.25 mL for doses <25 units, 0.3 mL for doses <30 units, 0.5 mL for doses <50 units and 1 mL for doses 50-100 units
True or false: A “short needle” (6-8 mm is appropriate for all pt’s with DM regardless of BMI
True
True or false: In most situations, pt’s with DM may safely reuse syringes and needles during a single day
True; however, reuse may carry increased risk of infection for some pt’s
Advise those who choose to reuse that markings on syringe may rub off and needle becomes dull w/ repeated use
Sharps containers that are ____ full should be closed and discarded according to community guidelines
three quarters
Insulin pump therapy is is a continuous basal amount of insulin usually given at ___ to ___ units per hour administered in addition to bolus doses given prior to meals
0.5-1.0 units per hours
What is a jet injector?
Needle free system that delivers insulin transcutaneously; they release a fine stream of insulin at high speed under high pressure to penetrate skin
What are the downsides to a jet injector?
expense, injection site pain, and required weekly maintainance
What is a pen device for insulin delivery?
Combine insulin container and syringe into single modular unit that allows for convenient insulin delivery
pens are available for almost all branded insulin products in a variety of types and styles. They are either reusable or prefilled, and both types hold cartridges of insulin
Where should unopended insulin be stored?
In the refrigerator
In general, in use insulin pens and vials may be stored at room temp for up to ____
28 days; however, providers should check specific product labeling
True or false: Afreeza adversely affects lung function
True; contains black box warning of acute bronchospasm in pt’s with DM w/ asthma and COPD. Need for ongoing spirometry and concerns about adverse lung function limits acceptance of inhaled insulin
Which test is useful to determine endogenous insulin production and type of DM?
C peptide levels
what is C peptide?
A substance made in the pancreas, along with insulin
Why is the initial measurement of c peptide useful?
To confirm dx of DM in person w/out a clear presentation and when absolute need for exogenous insulin is uncertain
What are common causes of hypoglycemia for pt’s who use insulin?
Excessive dose, delayed, missed, or insufficient food intake, too much unplanned physical activity
How is hypertrophy best prevented in patients that take insulin?
rotating injection sites
What should be done if a systemic reaction occurs to insulin?
Attending MD should be encouraged to contact insulin manufacturer for desensitization kit and procedure to follow
True or false: As a general rule, both insulin products to be mixed should be of the same brand
True
When mixing insulin, which type of insulin is usually drawn up first?
Rapid acting/regular followed by intermediate (limits potential for contamination, which may result in dose variance)
Manually prefilled syringes of either single formulations or mixtures of insulins are to be refrigerated and used within how many days?
21 to 30
Where may insulin be injected?
Subq tissue of upper arm, anterior and lateral aspect of the thigh, buttocks, and abdomen (with exception of 2 in inch radius around the navel)
When taking insulin, pt’s with DM should be instructed to count to what to ensure adequate insulin absorption/distribution under the skin?
5 (low dose)
10 (high doses)
Due to an acidic pH, which insulin may cause a mild burning when injected?
Glargine
Other insulin products retain a normal pH in solution
True or false: Rotating injection sites w/in a single area is not recommended
false; rotating w/in a single area is recommended rather than rotating to different area to decrease variability in absorption from day to day
