diabetes, renal, dialysis
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| Peak Rapid | 60-90min
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| Peak short acting | 2-3hr
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| peak intermidiate | 4-10 hr
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| long term insulin peak | None
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| which insulin is used for mealtime coverage for patients receiving intensive insulin therapy: | Rapid and short acting insulin
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| What would you teach a diabetic pt taking glipizide (Glucotrol)? | hypoglycemia, Weight gain, Allergic skin reactions, eczema, pruritus, erythema, Give drug before breakfast, do not use when pregnant, Avoid alcohol
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| Somogyi effect | (the “rebound” effect ) too much insulin causes hypoglycemia at night body over compensates leading to hyperglycemia in the morning. Increasing their food intake or lowering their insulin dose in the evening.
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| What is the most appropriate snack to offer to a diabetic to prevent rebound hypoglycemia | -if alert enought to swallow: give 15-20 g of a simple carb like juice or regular soda
-avoid foods with fat, they decrease the absorption of sugar.
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| metformin (Glucophage) and what RN needs to know about pt monitoring | Lactic acidosis. GI: Anorexia, nausea, vomiting, epigastric discomfort, heartburn, diarrhea, flatulence
Hypersensitivity: Allergic skin reactions, eczema, pruritus, erythema, urticarial, Reduce vitamin b levels
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| rosiglitazone (Avandia) what are you concerned about: (thiozolididiones) : | weight gain, Edema, Hepatic toxicity, anemia,
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| RN priorities for a pt admitted with ketoacidosis: | Airway, fluid, electrolytes.
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| Review early signs of chronic kidney disease (CKD) | GFR less than 60 for 3 months,
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| What labs does an RN need to monitor with gentamicin (Garamycin) administration | neuromuscular blockage, ototoxic to eighth cranial nerve (tinnitus,vertigo, ataxia, nystagmus, hearing loss), nephrotoxic.
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| How does an RN correct outflow problems for a pt receiving peritoneal dialysis | Bowel evacuation
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| 15. What kind of nsg interventions are important to stress out for a patient with chronic kidney disease (CKD): | teach on diet. S&S of electrolyte imbalance. Watch weight gain, SOB, Edema, lethargy
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| CKD, chemodialysis and nutrition - how do you manage your patient | K+ restrictions: greens, most fruits, brans, chocolate, nuts and seeds. Restrict protein because of Bun and Creatinine.
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| Compare and contrast continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis | CAPD- less diet restrictions, few complications, best for diabetes, less cardiovascular requirement, Dis: catheter migration, infection, hyperglycemia,
Hemodialysis: rapid fluid removal, effective k+ removal, less protein lost, lows trigricerides,
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| diabetic pt is on gentamicin - how do you monitor the pt (review adverse effects and labs associated with it) | monitor renal function, force fluids, monitor hearing acuity. Draw blood for peak levels 1 hr. after IM and 30 min - 1 hr. after IV infusion, draw blood for trough just before next dose. BUN and creatinine
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