Week 12: Chapter 13 Flashcards
What is the direct goal therapy for diabetes mellitus?
To keep blood glucose levels within normal range
How does the drug glucagon work to treat hypoglycemia?
It acts on the liver to release stored glucose from glycogen
Which S/S are associated with hypoglycemia or insulin shock?
Acute confusion
Cool clammy skin
Headache
Increased sweating
Which problem is a possible A/E of a drug from the sodium-glucose cotransport inhibitor class {canagliflozin (Invokana) and dapagliflozen (Farxiga)} ?
Dehydration
Which non-insulin antidiabetic drug can cause severe sunburn?
glyburide (Micronase) {Insulin Secretagogauges}
A pt with Type 1 DM asks why insulin must be injected in stead of taken as a tablet. What is your best answer?
Insulin is a small protein that would be destroyed in the digestive system if swallowed.
Why can people with DM2 use non-insulin antidiabetic drugs to control the disease?
People with DM2 continue to make pancreatic insulin
When starting to draw up and administer a dose of NPH insulin {Intermediate - Acting Insulin}, you find that the insulin in the vial is uniformly cloudy. What is your best action?
Draw up the medication
What is the most important issue to teach a pt who uses short acting insulin {Humulin R, Novolin R, ReliON R} before meals?
Eat a meal within 15 min of injecting the drug
A pt who uses insulin reports the area where he usually injects the drug is warm, red, and painful. What should you tell him to do?
Immediately call the prescriber and report the symptoms
Which statement made by a pt newly dx with DM1 indicates a need for more teaching?
I will keep a syringe and insulin bottle in my pocket at all times
With which non-insulin antidiabetic drugs(4) should you remain alert for the possibility of hypoglycemia even when it is the only drug prescribed?
- canagliflozin (Invokana) {Sodium-Glucose Cotransport Inhibitor}
- glipizide (Glucotrol) {Insulin Secretagogues}
- repaglinide (Prandin) {Meglitindes}
- sitagliptin (Januvia) {DPP-4 Inhibitors}
An older adult pt with DM2 who has been taking rosiglitazone (Avandia) {Thiazolidinedione’s / giltazones} for 1 month tells that her urine is the color of coffee. What is your best action?
Notify the prescriber immediately
{rosiglitazone (Avandia)
Class: Insulin Sensitizer / Category: Thiazolidinedione}
A patient with diabetes is scheduled for an angiogram. What antidiabetic medication does the nurse tell the patient to avoid within 48 hours after the procedure?
Metformin (Glucophage)
{Class: Insulin Sensitizer / Category: Biguanides}
Which precaution is most important to teach a patient who is newly prescribed sitagliptin (Januvia)?
Take a missed dose as soon as possible.
sitagliptin (Januvia) {DPP-4 Inhibitor}
The nurse is caring for a 12-year-old child with type 2 diabetes who has been ordered an adult dose of metformin (Glucophage). What should the nurse do next?
Give the medication
metformin (Glucophage) {Class: Insulin Sensitizer / Category: Biguanides}
A diabetic patient has been prescribed exenatide (Byetta). The nurse knows that what is the mechanism of action for this drug?
It triggers the pancreas to release insulin to handle the glucose ingested.
exenatide (Byetta) {Incretin Mimetics (GLp-1 agonist)}
The nurse is reviewing the actions of hormones. The nurse knows that what hormone is typically active early in the morning, or when the person is not eating, to maintain control of blood glucose levels?
Glucagon
The nurse is caring for a patient with diabetes. The nurse knows that what type of insulin is typically given before a meal?
Short acting
The nurse is caring for a patient with diabetes. The nurse knows that the goal for all diabetic drug therapy is?
euglycemia {The condition or state in which the blood glucose level is within normal ranges}
Before administering intermediate-acting insulin {Humulin N, Novolin N, ReliON N} to a patient, the nurse notices that the insulin vial is cloudy. What should the nurse do next?
Give the medication as ordered.
The nurse is preparing to administer an insulin injection to a patient. After cleansing the site with an alcohol swab, grasping a fold of skin in the nondominant hand, and inserting the needle, what should the nurse do next?
Do not aspirate for blood; do not massage the site after removing the needle.
Which signs and symptoms are associated with hypoglycemia? (select all that apply)
Shakiness, tremors
Headache
Sensation of hunger
Confusion
The nurse is caring for a group of diabetic patients. What type of diabetes is more common and is linked with obesity and a sedentary lifestyle?
Diabetes mellitus type 2 (DM2)
