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N254A > Quiz 6 - Insulin/Nutrition Assessment > Flashcards

Quiz 6 - Insulin/Nutrition Assessment Flashcards

1
Q

list some impacts of malnutrition

A
  1. inc risk of falls
  2. infections
  3. muscle wasting
  4. inc risk of fx
  5. dec mobility
  6. inc risk of hospital admission
  7. low mood
  8. low energy
  9. weight loss
  10. confusion
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2
Q

the patients nutritional status provides information on the pt ability to ___ and resist ____

A

heal and resist infection

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3
Q

Thinness/obesity is ____ a reliable methods to determine nutritional status

A

NOT

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4
Q

these are 4 categories of lab assessment of nutrition status

A
  1. biochemical
  2. dietary records
  3. clinical data
  4. anthropometric data
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5
Q

3 biochemical lab assessments of nutrition status

A
  1. serum albumin
  2. hemoglobin
  3. lymphocytes
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6
Q

4 clinical data lab assessments of nutrition status

A
  1. skin
  2. hair
  3. nails
  4. mucous membranes
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7
Q

3 anthropometric data lab assessments of nutrition status

A
  1. height
  2. weight
  3. BMI
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8
Q

BMI formula

A

weight in kg/(height in m)^2

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9
Q

in to m

A

multiply by .025

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10
Q

underweight BMI =

A

less than 18.5

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11
Q

normal BMI =

A

18.5 - 24.9

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12
Q

overweight BMI =

A

25 - 29.9

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13
Q

obese BMI =

A

30-39.9

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14
Q

extremely obese BMI =

A

greater than 40

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15
Q

4 examples of patient intake

A

oral, IV, blood, NG

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16
Q

estimates of intake are ___

A

inaccurate

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17
Q

I/O is done at ___ and over ___

A

shift and 24 hrs

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18
Q

NG tubes are placed when
1.
2.

A
  1. pt can’t eat by mouth/can’t eat enough

2. remove gastric contents (dec air swallowing, drug OD)

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19
Q

the large lumen is for

A

suction of gastric contents

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20
Q

the small lumen is an

A

air vent

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21
Q

the Salem sump NG tube has a

A

dual lumen

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22
Q

the Salem sump is for ____ and ____ suctioning

A

continuous and intermittent

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23
Q

the Levine tube is ___ lumen and for ____ suction only

A

single lumen and for intermittent suctioning only

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24
Q

tube size is measured by the ___ scale

A

French Fr

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25
Q

1 Fr =

A

1 Fr = diameter of 1/3 mm

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26
Q

the larger the French the ___ the tube

A

larger

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27
Q

the gold standard for checking NG tube placement is

A

x ray

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28
Q

NG tube placement can be confirmed with what two things

A
  1. aspirate GI secretions (pH between 1-4 of stomach contents)
  2. injection of air into NG tube and listening over gastric area
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29
Q

you should check gastric residuals ____ and ____

A

every shift and before admin of feeding or meds

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30
Q

___ NG tubes will clog more easily

A

smaller

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31
Q

you should ____ meds completely and mix with ____ before admin through an NG tube

A

CRUSH meds completely and mix with fluids before admin through an NG tube

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32
Q

___ is most effective way to clear NG tubes

A

water

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33
Q

with type 1 diabetes they can’t

A

produce insulin (beta cells destroyed by autoimmune process)

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34
Q

__% of the US pop is diabetic (___% of US adults)

A

7%, 50%

35
Q

__% over 60 have diabetes

A

21%

36
Q

___% of new diagnoses are children and adolescents

A

45%

37
Q

type 2 diabetes is a dec in ___ and ___

A

insulin prod and insulin sensitivity

38
Q

6 signs of diabetes

A
  1. polyuria
  2. polyphagia
  3. polydipsia
  4. fatigue
  5. numbness
  6. dec healing
39
Q

fasting blood glucose

A

125 mg/dL (70-130)

40
Q

random blood sugar

A

200 mg/dL

41
Q

with capillary blood glucose testing the ___ greatly impacts the results

A

SITE

42
Q

____ are the gold standard for capillary blood glucose testing

A

fingers

43
Q

name the three rapid acting insulins

A
  1. aspart (novorapid)
  2. glulisine (apidra)
  3. lispro (homolog)
44
Q

onset, peak, and duration of rapid acting insulin

A

onset: 10-15 min
peak: 1-1.5 hr
duration: 3-5 hr

45
Q

list the two short acting insulins

A

regular (humbling R and novolin R)

46
Q

onset, peak, duration of short acting insulins

A

onset: 30-45 min
peak: 2-3 hr
duration: 6.5 hr

47
Q

name the two intermediate acting insulins

A

NPH (humulin N and novolinge NPH)

48
Q

onset, peak, and duration of intermediate acting insulin

A

onset: 1-3 hr
peak: 5-8 hr
duration: 14-18 hr

49
Q

name the two long acting insulins

A

detemir (levemir) and glargine (lantus)

50
Q

detemir (levemir) onset, peak, and duration

A

onset: 1-2 hr
peak: 8-10 hr
duration: 12-24 hr

51
Q

glargine (lantus) onset, peak, and duration

A

onset: 1-2hr
peak: none
duration: 22-24 hr

52
Q

___ and ____ acting insulin are bolus

A

rapid and short acting

53
Q

___ and ____ acting insulin are basal

A

intermediate and long acting

54
Q

3 complications of insulin therapy

A
  1. local/systemic allergic rxns
  2. insulin lipdystrophy
  3. insulin resistance
55
Q

morning hyperglycemia is a ____

A

dawn phenomenon

56
Q

with morning hyperglycemia you have…

A

nocturnal surges of GH

57
Q

to treat morning hyperglycemia you should

A

give insulin at HS, not b4 dinner

58
Q

the somogyi effect is ___

A

nocturnal hypoglycemia followed by rebound hyperglycemia

59
Q

to treat the somogyi effect you should

A

dec evening dose of insulin

60
Q

hypoglycemia is a BS of

A

50-60 or less

61
Q

three causes of hypoglycemia

A

inc insulin, dec food, inc physical activity

62
Q

7 sx of hypoglycemia

A
  1. epinephrine and norepinephrine surge
  2. sweating
  3. inc HR
  4. palpitations
  5. nervousness
  6. hunger
  7. tremors
63
Q

___ effects are caused by hypoglycemia

A

CNS (H/A, lightheaded, confused, slurred speech, LOC, seizures)

64
Q

treatment for hypoglycemia

A

2-3 tsp of sugar/honey, 6-10 hard candies, 4-6oz of juice or soda, 3-4 glucose tablets then recheck BS in 15 min (if same sx repeat) once it is improved following with cheese, crackers, or milk

in extreme situations give glucagon and D50W

65
Q

3 clinical features of DKA

A

hyperglycemia, dehydration (electrolyte loss), acidosis

66
Q

6 sx of DKA

A
  1. 3 p’s
  2. orthostatic hypoTN
  3. ketosis
  4. GI s/s
  5. acetone breath
  6. HYPERventilation
67
Q

hyperglycemia is a BS of

A

300-800

68
Q

with hyperglycemia dx you have these 5 things

A
  1. BS 300-800
  2. acidosis
  3. electrolyte abnormalities
  4. inc BUN, CR, HCT
  5. dehydration
69
Q

treatment for hyperglycemia/DKA

A

rehydrate with NS, follow with .45% naCl then D5.45NS.

restore electrolytes, ECG, hourly BS, IV insulin, avoid bicarb (effects K+)

70
Q

an order for insulin will include

A

the units and volume in mL

71
Q

insulin is given ___ never ___

A

SQ, NEVER IM

72
Q

insulin syringes are for ___ insulin only

A

U-100

73
Q

insulin should be ___ temp when administered

A

room

74
Q

___ is the time period before the insulin starts to DEC the BS

A

onset

75
Q

___ is the time period where the insulin is most effective

A

peak

76
Q

____ is the time period where insulin continues to dec BS

A

duration

77
Q

____ is insulin delivered continuously over 24 hours, to keep BS in range between meals and overnight (can be different rates at different times)

A

basal

78
Q

____ is doses delivered at mealtimes to provide control for additional food intake

A

bolus

79
Q

when putting two types of insulin in a syringe you do ___ then ___-

A

clear then cloudy

80
Q

when putting air into vials of two different insulins you put air in the ___ first

A

cloudy (intermediate/long acting) first

81
Q

the ____ is drawn first

A

regular (rapid)

82
Q

if you draw too much ___ you need to start over

A

intermediate/long acting

83
Q

contact the physician for more than ___ units regular insulin for coverage

A

15

N254A (8 decks)

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