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NURS 2020 > Week 4 (Glucose) & Week 5 (Parenteral Equip) > Flashcards

Week 4 (Glucose) & Week 5 (Parenteral Equip) Flashcards

1
Q

What values of blood glucose are outside of the “acceptable range”?

A

< 2.2 mmol/L

> 20 mmol/L

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2
Q

What do you do if a patient’s blood glucose level is < 4 mmol/L?

A

Treat for hypoglycemia

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3
Q

What should you do if the PRE-operative blood glucose level is < 4 mmol/L or > 20 mmol/L?

A

Call the physician

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4
Q

What is the acceptable post-operative range for blood glucose?

A

Between 8 - 13 mmol/L

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5
Q

What should you do if the post-operative blood glucose level is > 13.5 mml/L?

A

Test urine for ketones

- if (+) monitor urine ketones q4h

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6
Q

Describe the characteristics of Type 1 diabetes

A

Auto-immune deficiency

  • beta cells stop producing insulin
  • typically early onset ( < 20 years old)
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7
Q

Describe the characteristics of Type 2 diabetes

A

Increased insulin resistance

- typically later onset ( > 40 years old)

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8
Q

What are the clinical S/S of hypoglycemia?

A
  1. Fatigue and malaise
  2. Trembling
  3. Irritability
  4. Headache
  5. Nausea
  6. Numbness
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9
Q

What are the clinical S/S of hyperglycemia

A
  1. Polyuria
  2. Polyphagia
  3. Polydipsia
  4. Fatigue
  5. Dry/itchy skin
  6. Poor wound healing
  7. Vision changes
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10
Q

What are some chronic complications of diabetes?

A
  1. Cardiovascular disease (HTN, heart disease, stroke)
  2. Kidney failure
  3. Blindness
  4. Nervous system damage
  5. Extremity amputations
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11
Q

How can hypoglycemia manifest?

A
  1. Hunger
  2. Tachycardia
  3. Sweating
  4. Nervous
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12
Q

What is a “normal” fasting blood glucose reading?

A

4 - 7 mmol/L

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13
Q

What is a “normal” blood glucose 2 hours after a meal?

A

5 - 10 mmol/L

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14
Q

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

A

Onset: 30 - 60 min
Peak: 2 - 4 hours
Duration: 6 - 8 hours Novolin R (or 8 - 12 hours Humulin R)

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15
Q

What is the onset, peak, and duration of long acting insulin?

A

Ultralente: 4 - 6 hours; 6 - 16 hours; and 4 - 36 hours
Glargine: 60 mins; none; 24 hours

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16
Q

What is the onset, peak, and duration of intermediate acting insulin (NPH)?

A

Onset: 60 min - 1.5 hours
Peak: 3 - 10 hours
Duration: 24 hours

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17
Q

What are the 4 ways to treat hypoglycemic episodes?

A
  1. 4 oz juice (or soda)
  2. 4 oz water with 4 sugar packets
  3. 8 oz low fat milk
  4. 50 % IV dextrose or glucagon if patient is not able to swallow
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18
Q

What is the only insulin that is cloudy?

A

Intermediate acting insulin ( NPH or Lente)

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19
Q

What is the site for intradermal injections?

A

Inner forearm

- assess in 48 - 72 hours if a skin test

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20
Q

What are the sites for insulin?

A

Rotate site within one region (intrasite rotation)

  • abdoment
  • back of arm
  • thigh
  • butt
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21
Q

What are the sites for subcutaneous injections?

A

Abdomen (not within 2” of umbilicus) or back of arm

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22
Q

What are the three sites for intramuscular injections?

A
  1. Ventrogluteal
  2. Vastus lateralis
  3. Deltoid
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23
Q

What is the angle of administration for intradermal injections?

A

5 - 15 degrees

24
Q

What is the angle of administration for insulin?

A

90 degrees = 2” pinch

45 degrees = 1” pinch

25
Q

What is the angle of administration for subcutaneous injections?

A

90 degrees = 2” pinch

45 degrees = 1” pinch

26
Q

What is the angle of administration for intramuscular injections?

A

90 degrees

27
Q

What is the needle length for intradermal, insulin, SC, and IM?

A

Intradermal: 3/8”
Insulin: 3/8 - 5/8”
SC: 3/8 - 5/8”
IM: 1 - 1.5”

28
Q

What is the needle gauge for intradermal, insulin, SC, and IM?

A

Intradermal: 25 - 30
Insulin: 25 - 30
SC: 25 - 28
IM: 19 - 25

29
Q

What happens to the diameter of the needle as the gauge size gets bigger?

A

Diameter gets smaller and smaller

- it’s opposite guys!

30
Q

What is different about an insulin needle compared to other needles?

A

It’s measured in units, instead of mL

31
Q

What is the volume of fluid that is injected for intradermal, insulin, SC, and IM?

A

Intradermal: 0.01 - 0.1 mL
Insulin: 1 - 100 UNITS
SC: < 1 mL
IM: < 3 mL (depending on the site)

32
Q

Which injection do you have to aspirate on?

A

Intramuscular!

- as per hospital policy …

33
Q

Why is the ventrogluteal site preferable?

A

Preferred site for medications that are larger in volume, more viscous and irritating

34
Q

Where is the bevel?

A

Opening of the needle (at the tip)

35
Q

Where is the plunger?

A

The thing that you push …

36
Q

Where is the barrel?

A

Where the drug sits

37
Q

Where is the needle?

A

If you don’t know …

38
Q

Where is the shaft?

A

The long part of the needle (between bevel and hub)

39
Q

Where is the hub?

A

The plastic connecting end of the needle

40
Q

What parts of the needle and syringe must remain sterile when preparing a medication (6)?

A
  1. Plunger
  2. Luer tip of barrel
  3. Inside of barrel
  4. Needle hub
  5. Shaft
  6. Bevel
41
Q

What do you put air into, an ampule or vial?

A

Vial

42
Q

When mixing two drugs in a syringe what must you first know?

A

Compatability!

- CAN they be mixed?

43
Q

When mixing two insulins in a syringe, which one is drawn up first?

A
  1. Regular (Humulin R) - CLEAR

2. Intermediate (NPH) - CLOUDY

44
Q

What is the BEST action to take after giving an injection in order to dispose of your equipment?

A

Do not recap and discard the equipment in the sharps container in the patient’s room
(- put on safety lock if applicable)

45
Q

What is the BEST action to take after preparing a medication?

A

Scoop cap

46
Q

WHY do you not recap after giving an injection?

A

Recapping after giving an injection would NOT protect you from a needle stick injury and potential infection
- may expose you to the most frequent route of exposure to blood borne disease for heath care providers

47
Q

What is the most common but preventable method of contracting blood borne illness among health care workers?

A

Needle stick injuries

48
Q

How can we as nurses prevent infection when administering injections?

A
  • aseptic technique
  • prevent contamination of solution
  • prevent needle contamination
  • prepare skin
  • wash hands before preparing medication
  • wear gloves while administering
49
Q

For needles, the higher the number, the _____ the size of the needle.

A

Smaller

50
Q

You’ve just administered an injection, and your patient starting asking you questions. What do you do?

A

Go to the sharps container. ASAP!

- answer questions after

51
Q

What do you do IF you have a needle stick injury?

A

GENTLY encourage bleeding - then wash with soap and water

  1. Follow BCIT policy
  2. Follow hospital policy
52
Q

What type of syringe does Heparin go into?

A

TB syringe

53
Q

Will a needle be contaminated if a drop of fluid runs down the needle and touches the syringe?

A

YES = because the needle is sterile but the syringe is not sterile

54
Q

Why do you aspirate before giving an IM (as per hospital policy)?

A

To make sure that you’re not in a blood vessel

55
Q

What do you need to do if you draw up from an ampule?

A

Use a draw needle WITH a filter!

- prevents glass from getting into the solution

NURS 2020 (6 decks)

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