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63 Cards in this Set
- Front
- Back
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What is the normal range of insulin
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0.5-1.0/kg/day
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What is the O, P, D of Rapid insulin?
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o: 15 min
P: 1/2-1 1/2hr D: 2-4 |
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What is the O, P, D of Regular Insulin?
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O: 1/2hr
P: 2-4 D: 6-8 |
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What is the O,P,D of Intramediate insulin?
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O: 1 1/2-2 1/2
P: 6-12 D: 18-24 |
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What is the O,P,D of Long Insulin?
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O: 4-6
P: 18-24 D: 36 |
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What does Sulfonylureas do?
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increase sensitivity to liver, increase insulin production
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What does nurse need to know about Sulfonylureas?
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-check pt for liver problems
-do not take with alcohol -take with meal |
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What common S/E of sulfonylureas?
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hypoglycemia
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Name a sulfonylureas...
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GLIPIZIDE
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What does Biguanides do?
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decrease hepatic glucose release, increase uptake in liver
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What does nurse need to know about Biguanides?
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-have an effect cholesterol
-check for renal pt -NO hypoglycemic effects |
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Name a Biguanide?
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Metformin (Glucophage)
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What are side effects of Metformin?
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-GI, metallic taste, wt loss
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What do Alpha Glucose do?
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slows the carb/glucose uptake in the GI
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Name a Alpha Glucose...
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Arcabose
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What does nurse need to know about Arcabose?
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-take prior to meal
-use glucose gel due to decreased GI uptake -do not mix with sulfonylureas |
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What do TZD (thiazolidiuedians)?
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-decreased insulin resistence
-decreased glucose production -does not cause hypoglycemia |
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Name a TZD?
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Actos/Avandia
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What is a teaching for Actos or Avandia?
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do not give to CHF pt, causes pulmonary edema
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What do Megitralides?
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increased insulin production
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Name a Megalitralide...
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Prandine
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WHat teaching for Megalitralide?
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-check for hepatic disease
-take prior to eals -hypoglycemia effect |
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What does peeing off proteins mean?
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ketosis - breakdown of protein in urine
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What ethnicities are at high risk?
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African american, Native American, Hispanics
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What B/P should we maintain?
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less than 130/80
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WHat effect of excersize on blood sugar?
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hypoglycemic effect
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What teachings prior to excersizing?
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eat a snack prior to excersizing, hypoglycemic effects may be longer
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What is Dawn effect?
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hyperglycemia early in AM
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What is Somogyi effect?
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initial hyperglycemia followed by rebound hyper
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what are fibrofatty deposits at injection sites, r/t not rotating sites properly?
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lipdystrophy
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What drugs may mask signs of hypoglycemia?
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beta blockers; tachy, palitations, diaphoresis
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Alchohol, NSAIDS, sulfonamides, antibiotics have what effect on blood sugar?
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addative hypoglycemic effect
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When do you give alpha glucosidase inhibitors?
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with first bite
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S/S hypoglycemia?
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shaking, sweating,dizzy, hunger, tachy, vision changes, headache, weakness
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What does nurse do for hypoglycemia?
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orange juice, and follow with a carb/protein snack
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S/S hyperglycemia
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extream thirst, frequent urination, dry skin, hunger, cision changes, Nausea
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What does nurse do for hyper glycemia?
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give insulin per orders
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If client is in severe hypoglycemic state, what med is given for emergency?
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glucacon pen
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Aerobic excersize effects blood glucose levels by...
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lowering insulin resistance
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How does Hypertension increase the risk of nephropathy in diabetic clients?
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increased renal vascular pressures result in tissue hypoxia and death
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Nurse gives NPH at 7am, when is expected hypoglycemic effect?
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4pm
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In client with hyperglycemia, nurse should monitor what lab?
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potassium
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Nurse monitors for hypoglycemia when, after giving Humalin around ...
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10 AM
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What clinical manifestation is seen in Type I but not Type II?
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weight loss
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Client getting regular insulin IV for DKA; what lab needs monitorin?
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potassium
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Client ordered for Humalog, nurse would teach...
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eat within 5-15 minutes of taking this medication
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What diagnostic study monitors blood glucose over several months
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hgb A1C
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term for waste product of protein metabolism?
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ketoanemia
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Greatest risk for develpment of DKA?
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infection
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Nurse correlates which clinical maifestation with DKA?
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tachycardia and orthohypotension
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When mixing insulin, nurse does what first?
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put air into NPH, then Rapid, then draw Rapid, then draw NPH
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Should DM pt take insulin and eat at random times?
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no day to day consistency in timing and amount of food intake help control bld glucose
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If glood flucose level higher than 250 and ketones present, client instructed to...
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not excersize until ketones are absent
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Client on glucocorticoids, nurse can expect insulin to...
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increase insulin need
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Illness, infection, stress do what to blood glucose level...
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increase
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what is blood sugar level for hypoglycemia?
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below 60
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Main clinical manifestation of DKA
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hyperglycemia, dehydration, ketosis, acidosis
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Main intervention for DKA
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restore blood colume against cerebral coronary damage
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Treat hyperglycemia with what IV solution
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NS, D5
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ER pt with HHNS, nurse would give what IV solution
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normal saline
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Insulin pump does what?
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gives small continuous bolus dose of REG insulin subQ, and client can self adminsiter prior to meals
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New client to be D/c on insulin injections, nurse will teach
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rotate sites
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ER pt with DKA, what labs would diagnose this?
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elevated blood glucose, low bicarb
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