Upgrade to remove ads
Only $35.99/year

Insulin

Terms in this set (78)

Rapid acting Peak, Onset and Duration
5-15 minutes, 1-2 hours, 5 hours max
Novolog
aspart
Humalog
lispro
Apidra
glulisine
Levemir
detemir
Lantus
glargine
Short acting POD
30 mins, 2-4 hours, 8 hours
Intermediate acting POD
1.5 hours, 4-12 hours, 24 hours
Basal POD
1 hour, none, 24 hours
Which type of insulin is used in critical care IV?
Short term "regular insulin" humulin-R or novolin-R
Which type of insulin requires food to be in front of them immediately?
Rapid acting: aspart, lispro, or glulisine
Flow of hormones in the endocrine system greatest to least
Hypothalamus(TRH), Pituitary(TSH), Thyroid(T3/T4)--> organs
Anterior Pituitary hormones
ACTH, TSH, Prolactin, Sex hormones
Posterior Pituitary hormones
Oxytocin, and ADH
how do you assess the thyroid
stand posterior and palpate/ask to swallow
Adrenal cortex hormones
Glucocorticoids(cortisol), Mineralocorticoids(Aldosterone), Also holds sex hormones
Adrenal Medulla hormones
Catecholamines, epinephrine, norepinephrine
Moon face is a symptom of what?
too much glucocorticoids/cortisol
Paper thin skin is a long term usage side effect of what?
Prednisone
Pancreatic Alpha cells are responsible for what?
releasing glucagon for increasing blood sugar
Pancreatic Beta cells are responsible for what?
releasing insulin
Type 1 DM doesnt have what?
Beta cells due to autoimmune problems attacking/killing beta cells
Most common cause of blindness 20-65?
DM
Neuropathy is only in DM1 not DM 2 T/F?
False, it is in both
Central obesity is recognized with which form of DM?
DM2
Why could diabetic patients have edema?
related to ADH/aldosterone imbalances
Low thyroid function can cause a decreased temp T/F?
True
A disproportion of the trunk(longer) and legs(shorter) is seen in what?
Glucocorticoid and mineralocorticoid imbalances
Primary problems with hormones are related to what?
the organs themselves
Secondary problems with hormones are related to what?
due to something other than the target organ
_____ tests are the easiest and best method for hormone levels/glucose
Blood
Urine tests are used for what? and for who?
to see if patient is spilling glucose, acetone, and glucocorticoids and the test is for those at risk of DKA
Iodine helps pick up the ____ for cancer and benign nodules
thyroid
CT scans are used in patients to determine if the ____ is the place of origin as well as a adrenal medulla condition known as ___
Brain; pheocromocytoma
Fasting blood glucose is indicative of DM when?
>126 done two times
Random blood glucose is indicative of DM when?
>200
Post-Prandial blood glucose is considered to be impaired glucose intolerant when?
140-199 after meals
Kidneys cannot handle a bood glucose greater than what?
180
GTT given when to pregnant women, how long, what to do if failed?
20-24 weeks pregnant, 1 hour to start 50g sugar drink then if failed another 3 hour 100g drink/test is to be done. interpreted by endocrinologist. if failed urine/blood required
HgbA1C is a study of glucose attached to Hgb lasting how long? desired results? non-diabetic results?
Hgb lasts for 90-120 days, testing blood sugar 3-4 months back, <7% is desired and non-diabetics usually have 4.5-5%
Urine tests are looking for what?
Sugar/Acetone/Ketones
If blood glucose is higher than 180 the kidneys will do what?
Spill lots of glucose(and everything else and pee a lot)
the 3 P's? which one doesnt DM 2 have?
Polyuria, Polydipsia, Polyphasia----type 2 doesnt have polyphagia
Only 5-10% of all diabetics are Type 1 T/F
True!
Sugar cannot reside in fat cells T/F
True!
Type 1 DM cant store ___ and they will then use fat for energy and become skinny/hungry.
Glucose--also think Atkins diet
The bodies consumption of fat instead of glucose releases what and results in what over time? what is a Key S/S?
Ketones and DKA; Fruity assed breath
Is there a genetic predisposition to DM1?
yes
Blood will have antibodies showing up in which case DM1 or DM2?
DM1-indicating the body is attacking the beta cells
Clinical Manifestations for DM1
3P's, weakness, malaise, weight loss, DKA possible,
Decrease in blood sugar looks similar to what type of symptoms?
increased SNS
4 counter-regulatories
Glucagon, Epinephrine(increases stress/glucose), Cortisol(increased stress-increasing sugars) GH increases glucose
when the body cant accommodate for all the counter-regulatories what happens?
they increase sugar/stress and the body cant produce enough insulin to bring it back down so the 3Ps show up.
In DM1 insulin may need to be ____ for the first 9 months after diagnosis due to some beta cells still being present
supplemented
Kids are often admitted with DKA T/F
True
What causes DKA, at what glucose level?
No insulin, body cannot store glucose in the cells, no energy so body steals fat using its energy resulting in the byproduct ketones resulting in metabolic acidosis or DKA---glucose level of 500+ usually
Breathing pattern and smell of patients breath in DKA?
Kussmals and fruity
Stress increases what related to diabetes?
glucose
DM1 diet?
50% carbs ( good carbs complex) 30% good fats 20% protein--encourage fiber to slow the emptying of the gut--Sodium intake<2g
Do Type 1 diabetics ever get oral hypoglycemics?
No, never
Type 2 diabetes can be treated with exercise and diet?
Yes but they are encourage to use insulin if they feel they cant control it
If a new patient presents with DKA what would be a teaching plan?
Diet, exercise, glucose/insulin balance/injections--dietary referral and Certified Diabetic Educator---DKA problematic in kids-alcohol/pizza/overnights
Type 2 DM Impaired glucose tolerance
body cannot store all the available glucose
Type 2 DM Insulin Resistance Syndrome presentations?
overwieght, HTN, HDL low LDL high,---diabetes is still preventable-
Gastric bypass proven effective for stopping DM2 onset? T/F
True
Weightloss of 5-7% can delay onset of diabetes?
Yes
Type 2 DM clinical manifestations
Polydipsia/polyuria, fatigue, irritability skin wounds heal poorly, vaginal infections(r/t sugar), Blurred vision, possible symptoms of HHNK
HHNK stands for what and S/S?
hyperglycemic-hyperosmolar-nonketotic-syndrome seen sometimes at 1000+ glucose and are seemingly "off"
--kidneys not functioning well d/t thick blood
--trying to spill sugar/losing some thru urine(lots of urine)
--can become dehydrated, ^ sodium levels altering brain thoughts
Assessing HHNK blood glucose how often?
Q1h--often will be in ICU
Insulin allows glucose and which electrolyte in the blood to be stored intracellularly?
Potassium- which is why HHNK patients might be in ICU d/t potassiums effects on the heart
process of food breakdown in stomach
break down of food, goes into blood stream, glucose in blood, then placed by insulin in liver/cells stored--K+ is brought with it
If you give insulin there could be a resultant drop in which electrolyte?
K+
Glucose/insulin bag can be hung to reduce what electrolyte
K+
If a patient has a glucose level of 500-1000 what should the nurse expect to hang?
NA w/ Insulin
Type 2 DM treatment
Diet-weight loss, restrict caloric intake, increase complex carbs
Exercise- Assists with weight loss, insulin cant place sugar-fat cell
Oral hypoglycemic agents- not as affected by exercise as insulin
If exercising be sure to have simple sugars on hand Q15min and where would you inject insulin prior?
in a muscle group not being used because otherwise insulin is dispersed too quickly
How long does insulin stay in your blood?
2 days
What is a serious risk for rapidly lowering blood sugars?
cerebral edema
Students also viewed