Insulin
The only insulin that can be given intravenousl.
What is...
Short acting insulin Ex. Regular
In which type of diabetes mellitus are oral anti-diabetics prescribed?
What is...
Diabetes mellitus type 2 or non insulin dependent diabetes mellitus.
The organ and mechanism of action for Biguanides Ex. Metformin.
What is...
Metformin decrease hepatic glucose hepatic stores.
What are the four counter regulatory hormones released when a patient is hypogylcemic?
What is...
Epinephrine, Glucagon, Cortisol, and Growth hormone
The route and angle insulin is administered to a patient.
Bonus: what is the length of the needle?
What is...
Subcutaneously and 45-90 degrees.
Bonus: 3/8 to 5/8, less than one inch of a needle
Insulin that cannot be mixed with any other insulin.
What is...
Long acting insulin Ex. Lantus
Nursing Implementation of Metformin administration.
What is...
Administer with food to minimize G.I upset.
The mechanism of action for short acting insulin Ex. Novolog aspart.
What is...
Decreases blood glucose by stimulating glucose uptake in skeletal muscle, inhibiting hepatic glucose production, and inhibition of lipolysis and proteolysis.
The initial signs and symptoms of hypoglycemia.
The initial signs and symptoms are related to fight or flight and include tachycardia, cool, clammy skin, dilated pupils, diaphoresis, altered mental status, etc.
Do you administer insulin to a patient who is NPO (nothing by mouth) for a diagnostic procedure?
What is...
No, the patient can become hypoglycemic if insulin is administered without food.
The peak time for long acting insulin Ex. Lantus
What is...
There is no peak time.
This organ‘s function test should be monitored periodically with oral antidiabetics.
What is...
Renal function test [BUN, creatinine, GFR].
The organ and mechanism of action thiazolidinediones Ex. Pioglitazone.
What is...
Helps insulin work better in muscle and fat cells by acting as an agonist at receptor sites also lowering glucose production in the liver.
How can hypoglycemia causes mental status changes or “stroke symptoms.”
What is...
The brain’s only source of energy is glucose. When glucose is limited, the brain loses its ability to function properly leading to mental status changes.
How far apart is the distance between insulin injections?
What is...
One inch from the previous site.
The peak time for rapid acting insulin Ex. Humalog lispro
What is...
5-15 minutes
The patient prescribed and taking metformin, should have what two vitamins monitored?
What is...
Vitamin B9 [folic acid] and Vitamin B12 [cobalamin]. Metformin decreases absorption.
The organ and mechanism of action for SGLT-2 Inhibitors Ex. Canagliflozin.
The SGLT-2 Inhibitors inhibit the SGLT-2 in the distal tubule which decreases reabsorption of glucose and increases excretion of glucose in the urine.
How does the hormone, glucagon, regulate blood sugar levels?
What is...
In the event of hypogylcemia, the pancreas releases an abundance of alpha cells. Alpha cells stimulate the liver to release glycogen. Glycogen is a carbohydrate that is broken down in the body to be used as glucose. Thus resulting in a raised blood glucose level.
Medication that must be discontinued 24 hours before and 48 hours after intravenous contrast dye use.
What is...
Metformin
The length of time insulin can be stored and handled.
What is...
28 days in a refrigerated condition
The reason first generation sulfonylurea antihyperglycemic medications are contraindicated or used with caution.
What is...
They can become dislodged from the proteins they bind to in the body, leading to life threatening and prolonged hypoglycemia.
The organ and mechanism of action of DDP-4 enzyme inhibitors Ex. Sitagliptin.
What is...
The DDP-4 enzyme inhibitors work in the small intestine and these medications slow the activation of incretin hormones that are responsible for glucose homeostasis. Leading to, an increase in insulin and decrease in glucagon levels.
How to correctly administer combination insulin in one syringe.
What is...
Inject prescribed units of air into cloudy, NPH insulin, and then inject units of air into clear, regular insulin.
Draw up the prescribed clear, regular insulin, and then draw the prescribed cloudy, NPH insulin, into the same needle.