LP 9

Question 1

When is Insulin used?

Answer 1

• when the blood glucose levels are high and need to be lowered
• made by the Beta cells

Question 2

When is glucagon used?

Answer 2

• when glucose levels are low and need to be raised

- produced by Alpha cells

Question 3

What are some metabolic changes that occur with Diabetes?

Answer 3

• hyperglycemia
• glycosuria
• polyphagia
• polydipsia
• lipolysis
• ketosis
• acidosis

Question 4

What are some diseases and disorders associated with diabtetes?

Answer 4

• atherosclerosis
• retinopathy
• neuropathy
• nephropathy

Question 5

What is type 1 diabetes?

Answer 5

• primary beta cells making absolutely NO insulin

- is auto immune

Question 6

What is type 2 diabetes?

Answer 6

• the pancreas makes either (a) less insulin or (b) the body rejects the insulin

Question 7

What are the different diabetic labs?

Answer 7

• neonates: 30-60 mg/dL
• infant: 40-90 mg/dL
• child under 2: 60-100 mg/dL
• child over 2: 70-110 mg/dL

Question 8

What are nursing considerations for insulin?

Answer 8

• know the onset peak and duration for the type of insulin being given
• know what the b,old sugar of your pts are before giving insulin
• monitor pts food intake
• don’t use discolored insulin

Question 9

What are some nursing implications for insulin?

Answer 9

• unopened vials are kept refidgerated
• once opened, may be kept at room room temp for one month or refrigerated for 3 months
• never freeze insulins, never store in direct sunlight or in a high temp
• opened vials of insulin lose their strength after three months

Question 10

What are the sxns of hypoglycemia?

Answer 10

• tachycardia, sweating, pallor, shakiness, cloudy mentation, hunger, headache

Question 11

What is something to teach your pt about hypoglycemia?

Answer 11

• the 15 and 15 rule: 15 grams of carbohydrates and then the pt should check blood sugar in 15 minutes

Question 12

What are the sxns of hyperglycemia?

Answer 12

• skin is hot, dry, dehydration, decreased perspiration, reparations are rapid and deep, acetone breath, decreased LOC, orthostatic hypotension, ketones present in blood and urine

Question 13

What is the action of Sulfonylureas (anti- diabetic)?

Answer 13

• stimulates insulin secretion from beta cells
• may enhance actions of insulin in liver, muscle, adipose tissues
• decreases insulin resistance

Question 14

What are some side effects of sulfonylureas (Anti- diabetes)?

Answer 14

• hypoglycemia
• GI distress, rash, and weight gain
• can cause bone marrow disturbances ad changes in blood count

Question 15

What is the action of Biguanides (anti- diabetic)?

Answer 15

• decreases liver glucose production
• decreased intestinal absorption of glucose
• increase use of glucose by muscle and fat cells

Question 16

What are the side effects of Bihuanides (Anti-diabetes)?

Answer 16

• bloating, nausea, diarrhea, can cause renal failure

Question 17

What is the action of DPP- 4 Inhibitor (Anti- diabetes)?

Answer 17

• minimizes inactivation of incretin hormones

- results in ore insulin for longer period of time and decrease hepatic glucose production

Question 18

What are the adverse effects of using DPP-4 (Anti- diabetes)?

Answer 18

• upper respiratory tract infections, runny nose, headache

Question 19

What is the action of Incretin Mimetics (Anti-diabetes)?

Answer 19

• incretin hormone release by small intestine
• slows breakdown of insulin
• slows rate of digestion

Question 20

What are the side effects of Incretin Mimetics (Anti-diabetes)?

Answer 20

• minor GI effects, weight loss, headache, can cause hypoglycemia

Question 21

What are some things to teach pts taking Anti- diabetic drugs?

Answer 21

• take exactly as prepared
• teach symptoms of hypoglycemia and how to treat
• do not skip snack or meals
• need to maintain healthy diet
• encourage weight losses d exercise
• monitor blood glucose levels
• avoid alcohol

Question 22

What type of diabetes can Anti- diabetes drugs be used with?

Answer 22

• type 2 ONLY

Question 23

What is the peak, onset, and duration of regular insulin?

Answer 23

• onset: 30-60 mins
• peak: 2-4 hrs
• duration: 6-12 hrs

Question 24

What is the onset, peak, and duration of NPH insulin?

Answer 24

• onset: 1-1.5 hr
• peak: 4-12 hrs
• duration: 24 hrs

Question 25

What is the onset, peak, and duration of Lispro (Humalog) insulin?

Answer 25

• onset: less than 15 mins
• peak: 30-90 mins
• duration: 2-5 hrs

Question 26

What is the onset, peak, and duration of Aspart (Novolog) insulin?

Answer 26

• onset: 10-20 mins
• peak: 1-3 hrs
• duration: 3-5 hrs

Question 27

What is the onset, peak, and duration of Glargine (Lantas) insulin?

Answer 27

• onset: 60-70 mins
• peak: none
• duration: 24 hrs

Question 28

What is the onset, peak, and duration of Detemir (Lememir) insulin?

Answer 28

• onset: 1-2 hrs
• peak: 3-6 hrs
• duration: 5.7-23.3 hrs

Question 29

What is important to know about Lantus and Levemir insulin?

Answer 29

• do not mix with other insulins

Question 30

Humalog and Novalog are what kind of insulin?

Answer 30

• rapid acting insulin