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78 Cards in this Set

  • Front
  • Back
What is diabetes
the inability to utilize glucose
Type I diabetes
no insulin produced by pancreas, insulin dependent
Type II diabetes
usually adult onset, noninsulin dependent, inadequate insulin
What is insulin
a hormone produced by beta cells in the pncreas that helps the cells use glucose
What are the signs of diabetes
polyuria, polyphagia, polydypsia
What are the S/S of hyperglycemia
extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, nausea
What are the S/S of hypoglycemia
shaky, sweating, dizzyness, anxiety, weakness, irritability, tachycardia
What is the treatment of diabetes
healthy living and weight, oral hypoglycemic agents, insulin
What are the actions of Sulfonylureas
Increase the secretion of insulin by the pancreas (long acting)
What are side effects of sulfonylureas
hypoglycemia due to hyperinsulinemia, skin rash, weight gain
What are the nursing implications for sulfonylureas
Caution with NSID's, ASA and beta blockers- can lead to hypoglycemia, cross sensitivity w/sulfa allergies
chlorpropamide (Diabinase)
glipizide (Glucotrol)-30min before meal
glyburide (micronase, Diabeta)-slow acting-good to cover night glucose
What is the action of biguanides
decreases hepatic glucose production, improves sensitivity to insulin
What are the side effects of Biguanides
30% have GI S/S (N/V, diarrhea, bloating, flatulence) caution w/CHF and renal insufficiency- watch creatinine
What are the nursing implications
Start w/lowest possible dose (ie, 2.5mg), give w/meals, hold for contrast studies
metformin (Glucophage)
What are the actions of Alpha-Glucosidase Inhibitors
Delays digestion and absorption of sugars in GI tract glucose levels rise more slowly
What are the Side effects of Alpha-Glucosidase Inhibitors
diarrhea, flatulence*** big time
What are the nursing implications for Alpha-Glucosidase Inhibitors
Slow titration of dosage, by itself, cannot cause hypoglycemia
Alpha-Glucosidase Inhibitors
acarbose (Precose)- Sulfa Drug
What is the action of Thiazolidinediones (TZD's)
1st choice for new dx w/obesity and insulin, makes cells more sensitive to insulin
What are the side effects for Thiazolidinediones (TZD's)
liver dysfunction- DC at the first sign
What are the nursing implications for Thiazolidinediones (TZD's)
monitor liver function
Thiazolidinediones (TZD's)
rosiglitazone (Avandia)
pioglitazone (Actose)
What are is the action of Miglitinides
stimulates pancreas to secrete insulin
What are the side effects for miglitinides
What are the nursing implications for Miglitinides
give 15 to 30 minutes before meals
repaglinide (Prandin)
What are the general nursing implications for hypoglycemic agents
Assess- glucose level and check side effects

Give p.o same time each day before or after meal

What are the important teaching points for hypoglycemic agents
Diabetic teaching, when and how to monitor glucose levels, s/s of hypoglycemia, when to call a physician
Rapid-Action insulin
Humulin R
Humalog (Lispro Insulin)
What is the onset, peak, and duration for Rapid acting insulin
Onset- 15min to 1hr
Peak- 1/2 to 3hr
Duration- 5 to 8hr
Intermediate-Acting insulin
Humulin N
Humulin L
What is teh onset, peak, and duration for Intermendiate-acting insulin
Onset- 2 to 6hr
Peak- 4 to 14hr
Duration- 16 to 20hr
Long-acting insulin
What is the Onset, Peak, Duration for long-acting insulin
Onset- 4 to 8hr
Peak- 4 to 30 hr
Duration- 18 to 36hr
Combination insulin
Humulin 70/30
Novolin 70/30
What is the Onset, Peak, Duration, for combination insulin
Onset- 1/2hr to 1hr
Peak- 1/2hr to 3hr
Duration- 18 to 24hr
What are the adverse effects of insulin
hypoglycemia (insulin shock)
hyperglycemia (ketoacidosis)
What route is insulin given
**destroyed orally**
thigh-slowest (unless exercise)
IV when unstable
At what glucose level sould a nurse hold insulin
glucose level is < 70
When should a nurse test glucose levels
before meals and insuline administration
What are important nursing implications for insulin
-Know where a meal tray is **w/fast acting insulin
-Have appropriate strength for syringe
-document injection site (rotate site)
What is the action of Glucogon
Hormone that stimulates the liver to release stored glucose
When is Glucogon used
In emergancy situations with insulin induced hypoglycemia, when admin of glucose is not feasible, promotes sugar
What are the functions of Glucocorticoids
Metabolism, anti-inflammatory, Potenitiates vasoconstirction, decreases calcium absorption
What are the uses for Glucocorticoids
Replacment therapy for addison's disease, Anti-inflammatory- RA, Lupus, M.S
head trama or surgery, shock/trama, respiratory disorder
What are the side effects of Glucocorticoids
Trunk obesity and thinning extremities, Buffalo hump and moon face, weight gain, protuding abdomen, muscle wasting
What are the nursing implicaitons and teaching for Glucocorticoids
Admin in the a.m, Do not stop suddenly, assesment, diet increase protein, calcium, K+, and decrease in Na, med alert, take w/milk
What is the action of Mineralocorticoids (Aldosterone)
stimulate the retention of sodium and exretion of K+
What is Mineralocorticoids used for
replacement therapy when glucocorticoid replacement is not enough to maintain sodium levels (Addison's)
What are the side effects for Mineralocorticoids
edema, hypernatremia and hypokalemia, CHF and Hypertension
fludrocortisone (Florinef)
What are the actions of T3 and T4
Increase metabloic rate of tissues
What are the side effects of an increase of metabolic rate
Increase RR, P, temp, increase of O2 consumption, increase of metabolism of CHO, protieins and fats
What are the S/S of hyperthyroidism
tachycardia, hypertension, palpitaions, insomnia, increased appetite w/weight loss
What are the S/S of hypothyroidism
bradycardia, decreased B/P, weight gain, sleepy, lethargic
Thyroid Hormone
levothyroxine (Synthroid)
liothyronine (Cytomel)
What are the nursing implications for thyroid hormone
Monitor response- B/P and chest pain, dont skip a dose, hyperthyroidism or chest pain call doc., take in am.
What are the actions of antithyroid agents
inhibit the produciton of thyroxine (T4)
What are the uses for antithyroid agents
hyperthyroidism, before thyroid surgery for the purpose of decreasing vascularity
What are the S/S of antithyroid agents
hypothyroidism, rash, N/V, H/A
Antithyroid agents
proplythiouracil PTU, Tapazole, Propacil, Lugol's solution, I131
What are the nursing implications for antithyroid agents
monitor, use straw w/liquid iodine prep, watch iodine consumption OTC meds, seafood, table salt
What are the actions of androgens
stimulate the growth of secondary sex characteristics, accessory sex organs, increase formation of muscle mass
What are the uses for androgens
replacment therapy, breast cancer in women, tumors, refractory anemias, AIDS
What are the side effects of androgens in men and women
women- masculinization and amenorrhea

men- gynecomastia (man boobies) impotence, H/A, mental changes- rage, aggressive behavior
testosterone, Testoderm, Halotestin
What is the action of estrogen
Growth and development on vagina, uterus, F-tubes, breasts, secondary sex characteristics fat pads, changes of endometrium (builds up)
What are the uses for estrogen
inoperable prostatic cancer, hysterectomies, decrease genitilia atrophy, hot flashes, treat underdeveloped ovaries and dysmenorrhea, contraceptives
What are the side effects for estrogen
N/V, abdominal distention, cramps, fluid retention and weight gain, breast swelling and tenderness
What are the serious effects of estrogen
hypertension, thrombophlebitis, MI, embolism, CVA, breast cancer
conjugated estrogen (Premarin)
estradiol (Estrace, Ogen)
estradiol transdermal system (Estraderm)
What are the nursing implications for estrogen
educate about warnings, monitor B/P and weight, pap test, no smoking- Increases breast cancer CV disease
What is the action of progesterone
endometrial thickening, prepare for implantation, develops placenta
What are the uses for progesterone
threatened abortions/preterm labor, amenorrhea, conraception, maintenance of pregnancy
medroxyprogesterone (Provera)
norethindrone (Norlutin)
Depoprovera IM
What are the side effect for progesterone
Moodiness, weight gain, erratic bleeding vs amenorrhea.... Fertility treatment, plan B contraception, "morning after" pill