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diabetes exam5

roadmap exam 5 DM

QuestionAnswer
RAPID ACTING INSULINS names, onset, peak, duration, admin Lispro(Humalog)/ Aspart(novolog)/Glulisine(apidra) O=5-15, P=1hr, D=2-4hrs admin 5-15 min before or with food
REGULAR-SHORT ACTING INSULINS names, onset, peak, duration, admin HumalogR, NovolinR, Iletin IIR ALL CLEAR SOLUTIONS/ O=20-30, P=2-3hr, D=4-6hr admin 20-30min b4meals ONLY INSULIN APPROVED FOR IV USE
INTERMEDIATE INSULINS names, onset, peak, duration, admin NPH / NovolinL/ NovolinN/ Lente O=2-4hrs, P=4-12hrs, D=16-20hrs CLOUDY SOLUTIONS / draw up last!! eat at onset of action 2-4hrs
LONG ACTING/BASAL/PEAKLESS INSULINS names, onset, peak, duration, admin DO NOT MIX WITH OTHER INSULINS MUST ADMIN SEPARATELY once daily injection Glargine(Lantus) / Detemir(levemir) O=1hr, no peak, D=24hrs
insulin is secreted by the __ cells glucagon is secreted by the __ cells insulin = pancreatic Beta cells glucagon = pancreatic Alpha cells both from islets of Langerhans
RAPID ACTING INSULINS names, onset, peak, duration, admin Lispro(Humalog)/ Aspart(novolog)/Glulisine(apidra) O=5-15, P=1hr, D=2-4hrs admin 5-15 min before or with food
REGULAR-SHORT ACTING INSULINS names, onset, peak, duration, admin HumalogR, NovolinR, Iletin IIR ALL CLEAR SOLUTIONS/ O=20-30, P=2-3hr, D=4-6hr admin 20-30min b4meals ONLY INSULIN APPROVED FOR IV USE
INTERMEDIATE INSULINS names, onset, peak, duration, admin NPH / NovolinL/ NovolinN/ Lente O=2-4hrs, P=4-12hrs, D=16-20hrs CLOUDY SOLUTIONS / draw up last!! eat at onset of action 2-4hrs
LONG ACTING/BASAL/PEAKLESS INSULINS names, onset, peak, duration, admin DO NOT MIX WITH OTHER INSULINS MUST ADMIN SEPARATELY once daily injection Glargine(Lantus) / Detemir(levemir) O=1hr, no peak, D=24hrs
insulin is secreted by the __ cells glucagon is secreted by the __ cells insulin = pancreatic Beta cells glucagon = pancreatic Alpha cells both from islets of Langerhans
action of insulin storage hormone, moves glucose from blood to muscles, liver, and fat cells
why do muscle liver and fat cells need insulin -transport/metabolize glucose for energy -stimulate storage of glucose as glycogen in liver -signals liver to stop releasing glucose -enhances fat storage -accelerates transport of amino acids(from protein) into cells
when is glucagon released & what does it do released when low glucose levels tells liver to release stored glucose
how does exercise lower blood glucose increases uptake of glucose by muscles and improves insulin utilization also increases HDL, and lowers triglycerides & cholesterol
DM pts should avoid exercise when... ketones in urine and glucose over 250
snacks and exercise for DM pts eat a 15gm carb snack prior to exercise, if strenous, eat snack after and @ bedtime TO AVOID HYPOGLYCEMIA FS - before, during, after exercise
hypoglycemia blood glucose =/<50-60 -too much insulin -too little food -excessive physical exercise
3 main causes of DKA missed insulin doses illness/infection undiagnosed diabetes
s/s of DKA Hyperglycemia (too little insulin)/ dehydration & electrolyte loss / acidosis / blurred vision, weakness, headache
evidence of ketoacidosis serum bicarb 0-15 pH 6.8-7.3 low sodium/potassium increased BUN, creatinine, hematocrit
treatment of DKA 1) 0.9% sodium chloride IV (increase volume/reverse dehydration) 2) 0.45 sodium chloride IV HYPOTONIC 3)glucose =/<300 = 5%dextrose&water (D5W) 4)Regular insulin IV, slow 5U/hr WATCH ECG, AND POTASSIUM LEVELS
HHNS s/s hypotension dehydration tachycardia neuro signs-hallucinations/periph tingle
treatment of HHNS same as DKA watch ECG, and fluid overload
Created by: rtcdavis