Insulin
what is the difference in U-100 and U-500?
100 units per mL and 500 units per mL
what is the major route for insulin and what degree angle should you give it?
subcutaneous; 90 degree angle
What are some med names of sulfonylureas?
glipizide, gyburide, glimepiride
An adult with type 2 diabetes is taking metformin 1,000 mg two times everyday. The client asks the nurse about having an alcoholic drink. What should the nurse educate the pt on about this situation?
Which type of diabetes usually onset in people younger than 20?
Type 1
What is the onset and peak of rapid-acting insulins?
Onset 5-15 minutes
peak: 30 min- 2 hours
should you draw up clear or cloudy solutions first?
Clear to cloudy
What are some side effects of sulfonylureas?
GI symptoms, rash, hypoglycemia, wt gain
What is the class of metformin
biguanide (antidiabetic)
Which type is from lack of insulin production which results in hyperglycemia?
type 1
What are clear insulin solutions?
Rapid-acting, short-acting and long-acting
Which insulins should you never mix?
Glargine (Lantus) or Detemir (Levemir)
What kind of diet should pts on sulfonylureas eat?
carbohydrate consistent diet
A pt has recently been prescribed Metformin. They have been complaining of feeling nausea, diarrhea, and abdominal discomfort. What should you tell this pt?
these syptoms will usually subside after a few months
What is type 2 diabetes caused by?
What are the generic names of the following?
humalog
novolog
apidra
lantus
levimir
lispro
aspart
glulisine
glargine
detemir
How much insulin would you administer for a CBG level of 331 mg/dL on the basis of the following sliding scale order?
HumulinR U-100 based on result of finger stick q8h:
CBG of 0-180 mg per dL ................................. No coverage
CBG of 181-240 mg per dL ............................. 2 units subcut
CBG of 241-300 mg per dL ............................. 4 units subcut
CBG of 301-400 mg per dL.............................. 5 units subcut
CBG of >400 per dL ....................................... 8 units subcut and call HCP. Repeat CBG in 2 hours
6 units Humulin R subcut after checking with another nurse.
You should only use sulfonylureas if what?
if some pancrease beta cells function
The pt who is prescribed metformin was just told they are going to be having IV contrast in the morning. What should the nurse do with the metformin in the morning and following the contrast?
Hold the medication in the morning and hold the med 48 hours after the IV contrast
This is because this med is should be used carefully on renal pts
What are the warning signs of of type 1 diabetes?
What are the warning signs of type 2 diabetes?
Increased thirst and urination, constant hunger, wt loss, blurred vision, tiredness
fatigue, slow wound healing, pain or numbness in hands/ feet
How many nurses should check insulin? How should it be checked?
2 nurses; the second nurse should tell the first nurse what they see drawed up
What is the sequence for mixing insulins?
1. wash hands
2. inspect expiration dates
3. gently roll vials in palm to even suspension
4. cleanse tops of both vials with alcohol
5. inject air equal to dose of cloudy insulin into that vial first (do not touch solution with needle)
6. remove needle from cloudly vial
7. using same syringe, inject air equal to needed dose into clear type mixable insulin; invert bottle and withdraw
8. remove needle from clear insulin vial and check for bubbles (small bubbles can alter dose). Tap, if necessary, to remove bubbles
9. Invert cloudy insulin vial, insert needle into solution, and withdraw to desired total dosage. Stabilize plunger to avoid contamination with or loss of clear insulin
10. the total volume should equal the total number of unites ordered.
What are the advantages and disadvantages of sulfonylureas?
Advantage: COST; not as many drug drug contraindications
Disadvantage: burn out the beta cells faster
The pt has just started taking metformin and has asked the question, "is this med going to make me gain wt?", what is your response?
The pt has also asked, " I dont want to feel hypoglycemic" , What is your response?
This med will not make you gain wt and will not make you hypoglycemic
____________ decreases blood sugar, ______________ increases blood sugar
insulin
glucose