roadmap exam 5 DM
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
🗑
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| 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
🗑
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| 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
🗑
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| 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
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| action of insulin | storage hormone, moves glucose from blood to muscles, liver, and fat cells
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| 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
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| when is glucagon released & what does it do | released when low glucose levels
tells liver to release stored glucose
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| how does exercise lower blood glucose | increases uptake of glucose by muscles and improves insulin utilization
also increases HDL, and lowers triglycerides & cholesterol
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| DM pts should avoid exercise when... | ketones in urine and glucose over 250
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| 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
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| hypoglycemia | blood glucose =/<50-60
-too much insulin
-too little food
-excessive physical exercise
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| 3 main causes of DKA | missed insulin doses
illness/infection
undiagnosed diabetes
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| s/s of DKA | Hyperglycemia (too little insulin)/ dehydration & electrolyte loss / acidosis / blurred vision, weakness, headache
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| evidence of ketoacidosis | serum bicarb 0-15
pH 6.8-7.3
low sodium/potassium
increased BUN, creatinine, hematocrit
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| 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
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| HHNS s/s | hypotension
dehydration
tachycardia
neuro signs-hallucinations/periph tingle
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| treatment of HHNS | same as DKA
watch ECG, and fluid overload
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