PHARMACOLOGY
Treatment for Type 1 Diabetes
What is insulin?
Bonus points: 100- Why?
Hormone produced by beta cells
What is insulin?
Proper technique for performing finger stick
use alcohol wipe
use side of finger
discard first drop of blood
DKA is an abbreviation for this diabetic complication
What is Diabetic ketoacidosis?
this should be done at every diabetic appointment
What is examine patient feet for sores and s/s infection?
This oral anti- diabetic medication is used to treat Type 2 DM and is drug of choice, must be stopped 24-48 hours before use of IV contrast media and not resumed until 48 hours after.
What is Metformin/Biguanid?
Bonus- 100 points- What lab test should be checked?
This insulin can be administered SQ or IV, is rapid acting and often given as a bolus to cover patients glucose spikes at mealtimes
What is REGULAR INSULIN?
Nursing education given to patients about sick days
take meds (insulin or antidiabetic agents) as usual
test blood glucose every 3-4 hours
report elevated levels to provider
drink plenty fluids
report vomiting/diarrhea to provider
HHS is an abbreviation for this diabetic complication
What is HYPERGYLCEMIC HYPEROSMOLAR SYNDROME?
Name 3 risk factors for macrovascular complications for chronic diabetics
obesity
smoking
hi fat diet
sedentary lifestyle
HTN, HLD, uncontrolled DM
This drug classification increase insulin production,
side effects are weight gain, GI affects
What are SULFONYLUREAS?
This insulin appears cloudy, must be rolled between palms to mix prior to administration, peaks 4-10 hours after SQ injection and can be mixed with only regular insulin.
What is NPH INSULIN?
Educate patient three things that can affect blood sugar levels, need to test levels frequently
stress
illness
exercise
Rapid deep breathing, symptom that accompanies acritical acute hypergylcemic complication
What are Kussmaul's respirations?
Pathophysiology of diabetic neuropathy
What is persistent hyperglycemia?
Bonus 100- How does this lead to nerve damage?
This side effect of insulin therapy is less prevalent with human insulin and is caused by atrophy of subcutaneous tissues
What is LIPODYSTROPHY?
What hormone increases blood glucose levels to protect the brain and other tissues, helps maintain blood glucose levels during sleep and acts as an antagonist?
What is GLUCAGON?
Hormone responsible for elevated glucose in diabetic patients
What is cortisol?
Bonus 100-What can cause elevated cortisol levels?
Normal expected lab finding for patient in DKA
blood glucose > 300
pH<7.30
serum bicarb < 15mEq/L
Mod to Lg ketones in blood and urine
Damage to small blood vessels in this area of the kidney leads to nephropathy
What are GLOMERULI?
Bonus 100- What is the disease that this causes in diabetic patients?
The mechanism of action of this class increases urinary excretion of glucose by inhibiting a certain transporter responsible reabsorbing a majority of glucose that is filtered by the kidneys
What is SGLT-2 inhibitors?
Jardiance, Invokana, Farxiga
Counter-regulatory hormones (glucagon and epinephrine) cause the liver to convert glycogen to glucose causing elevated fasting blood sugar levels also known as this.
What is the SOMOGI Effect?
Bonus: What is the treatment? extra 200 points
Clinical manifestations of hypoglycemia to teach patients (Must name at least 6)
what are confusion, sweating, tremors, Hunger, weakness, drowsiness or lethargy, visual disturbances, difficulty concentrating?
Bonus- 200- What is treatment for conscious and unconscious patient?
Nursing management for patient in severe DKA
(4 steps)
aggressive fluid resuscitation
bolus insulin, followed by insulin drip
potassium replacement
sodium bicarbonate
Bonus 100- When do you add D5% to IVF?
Name three other types of nerve related conditions affecting diabetic patients
What is gastroparesis, sexual dysfunction, neurogenic bladdar, cardiovascular diseases affecting blood vessels