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insulin
diabetes and insulin
| Question | Answer |
|---|---|
| Insulin | Required for type 1 |
| Perscribed for | pt. with type 2 who canot control blood glucose by other means |
| human insulin | *most widely used*cost effective*decrease likelihood of allergic reation |
| conventional insulin regimen | for terminally ill, the frail or patients who are completely unwilling or unableavoid acute complicationsshort and intermediate acting |
| intensive insulin regimen | *complex*maintains blood glucose*Prevents or slows the progression of long_term diabteic complications*Risk of severe hypoglycemia |
| rapid acting | lispro |
| short acting | regular |
| intermediate acting | NPH or Lente |
| Long-acting | Ultralent, Lantus |
| admin of insulin | SQ for selfIVinhaled |
| what are oral agents | not insulinwork to improve the mechanism in which insulin and glucose are produced and used by the body |
| 5 oral agents | 1st gen2nd genbiguanidesalpha glucosidase inhibitorsthiazolidinediones |
| Drug therapy oral agents: drugs that affect blood glucose levels | beta adrenergic blockersthiazide loop diuretics |
| Acute complicationso of diabetes | *hypoglycemia*diabetic ketoacidosis*hyperglycemic hyperosmolar nonketotic syndrome or coma (HHNS) or (HHS) |
| hypoglycemia | abn. low blood glucose level (below 50-60 mg/dl)causes too much insulin or oral hypoglycemic agents, too little food and excessive physical activity |
| ADRENERGIC manifestations of hypoglycemia | sweeting, tremors, tachycardia, palpitations, nervousness, hunger |
| management of hypoglycemia | treatment is immediate15 g of fast acting concentrated carb: 3 or 4 glucose tabs, 4-6 ounces of juice or regular soda, 6-10 hard canides, 2-3 teaspoons of honey.retest blood glucose in 15 min. retreat if > 70mg/dl or if symptoms persis more than 10 - 15 m |
| EMERGENCY: if patient cannot swallow or is unconcious | subQ or IM glucagon 1 mg25-50 mL 50% dextrose solution IV |
| diabetic ketoacidosis is caused by | an absence of or inadequate amount of insulin resulting in abnormal metabolism or carg, protein, and fat. |
| clinical features of DKA | hyperglycemiadehydrationacidosis |
| manifestations of DKA | polyuria, polydipsia, blurred vision, weakness, headache, anorexia, abdominal, pain, nausea, vomiting, acetone breathhyperventilation w/ kussmaul resp.mental status change |
| treatment of DKA | rehydration with IV fluidIV continuous infusion of regular insulinreverse acidosis and restoration of electrolyte blance |
| treatment of DKA: monitor | blood glucoseEKG and electrolyte: potassiumVS lung assessments, signs of fluid overload |
| HHNS | LACK OF INSULIN,KETOSIS IS MINIMAL OR ABSENT HYPERGLYCEMIc CAUSES OSMOTIC DIURESIS W/ LOSS OF WATER AND ELECTROLYTESHYPERMATREMIA AND INCREASED OSMOLATLITY OCCUR |
| MANIFESTATIONS OF HHNS | HYPOTENtION, DEHYDRATION, TACHYCARDIA, NEUROLOGIC SIGNS, HIGH MORTALITY |
| SICK DAY RULES | *take insulin or oral anitdiabetic agents as usual*test blood glucose*test urine ketones every 3-4 hours*report elevated glucose levels*if you take insulin, you may need supplemental does or regular insulin every 3-4 hours*if unable to follow meal plan, s |
Created by:
leah_76
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