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Ch 42 anti diabetic

Terms in this set (35)

Insulin
-Hormone manufactured by beta cells of pancreas
-Controls the storage and utilization of amino acids and fatty acids
-Lowers blood glucose levels by inhibiting glucose production by liver
diabetes mellitus
a chronic condition in which insufficient insulin is produced by the pancreatic beta cells (type 1) or in addition to less insulin produced the body cells become resistant to insulin (type 2)
How many cases of diabetes mellitus are type 2
90-95%
How is Type 2 diabetes managed?
Healthy eating, physical activity, oral medications
polydipsia
Excessive thirst
polyphagia
Excessive hunger or increased appetite
polyuria
excessive urination
Risk factors for type 2 diabetes
Obesity
Older age
Family history of diabetes
History of gestational diabetes
Impaired glucose tolerance
Minimal or no physical activity
Race/ethnicity (African Americans, Hispanic/Latino Americans, Native Americans, and some Asian Americans)
properties of insulin
onset, peak, duration
Actions of insulin
-Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue
-Treats hypokalemia in combination with glucose
-Controls type 1 diabetes mellitus, type 2 diabetes, severe diabetic ketoacidosis
onset
when insulin first begins to act in the body
peak
when the insulin is exerting maximum action
duration
the length of time insulin remains in effect
Adverse reactions of insulin
Hypoglycemia; hyperglycemia;
allergic reaction
Insulin Contraindications
pts with hypersensitivity, hypoglycemia
insulin preadministration
Make general assessment of skin, mucous membranes, and extremities, with attention given to any sores or cuts and any ulcerations or other skin or mucous membrane changes
Hyperglycemia may occur when
The patient eats too much food; too little or no insulin is given; the patient experiences emotional stress, infection, surgery, pregnancy or an acute illness
Hypoglycemia may occur when
pt eats too little food, the pt has drastically increased demands from illness or activity, the insulin given is incorrectly measured and is greater than prescribed
Hyperglacemia
too little insulin in the bloodstream ( elevated blood sugar)
Hypoglacemia
too much insulin in the bloodstream( low blood sugar)
Mixing Insulin
Inject air into NPH (cloudy)
Change needles
Inject air into regular (clear)
Withdraw regular
Withdraw NPH
must be done right before administration
Regular is fast acting
Regular insulin is the only insulin that may be given intravenously or intramuscularly and is given via these routes in emergency situations only
Oral Antidiabetic Drugs
used for type 2 DM,
Types of oral antidiabetic drugs
Sulfonylureas, biguanides, alpha (α)-glucosidase inhibitors, meglitinides, thiazolidinediones
Metformin (Biguanide)
used to treat type 2 diabetes
when to withhold meglitinides
Instruct patient not to take the drug if a meal is skipped
Protein and fat metabolism also require insulin.
true
A client is prescribed miglitol. The nurse would instruct the client to administer this drug at which time?
3 times a day with the first bite of a meal
A client is being discharged after being diagnosed with diabetes. The client is being taught how to monitor his blood glucose. After teaching the client, which statement indicates to the nurse that additional teaching is needed?
"I should prick the tip of my finger to get the blood."
A client who is receiving metformin develops lactic acidosis. When planning the care for this client, which nursing diagnosis would the nurse most likely identify?
ineffective breathing pattern
A nurse is caring for a client with type 2 diabetes receiving a meglitinide. The nurse reviews the client's medical record based on the understanding that which condition would contraindicate the use of this drug?
Diabetic ketoacidosis
A nurse is caring for a client who has developed a hypoglycemic reaction. Which of the following interventions should the nurse perform if swallowing and gag reflexes are present in the client?
give oral fluid or candy
A nurse at a health care facility is assigned to administer insulin to the client. Which of the following interventions should the nurse perform before administering each insulin dose?
inspect the previous injection site for inflammation
A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this client?
observe the client for hypoglycemic episodes
After administering insulin detemir to a client with diabetes, the nurse suspects that the client is developing hypoglycemia based on assessment of which of the following?
headache, confusion, diaphoresis
A nurse is preparing a presentation for a local community group about diabetes. Which of the following would the nurse include when describing type 1 diabetes? Select all that apply.
Occurs before age 20
Insulin supplementation required for survival
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