Essential Insulin and Diabetes Management: Key Exam Insights
School
Hillsborough Community College**We aren't endorsed by this school
Course
NUR 1141
Subject
Nursing
Date
Dec 10, 2024
Pages
6
Uploaded by MinisterIronLobster6146
EXAM 2 PHARM NEED TO KNOWS ANSWERED1. How We Store Insulin:Storage:oInsulin should be stored in the refrigeratorwhen unopened. Once opened, it can be kept at room temperaturefor up to 30 days to reduce injection discomfort.oAvoid exposure to direct sunlightand high temperaturesas this can degrade insulin's effectiveness 2. Why We Rotate Injection Sites:Reason: Rotating injection sites prevents lipodystrophy(abnormal distribution of fat in the skin), which can interfere with insulin absorption. Regularly using the same spot may lead to areas of hardened tissue, reducing insulin’s efficacy 3. Administration of Insulin:Route: Insulin is administered subcutaneously(SubQ). Regular insulincan be given IVin critical settings, such as in the ICU for diabetic ketoacidosis.Oral insulinis not viable as stomach enzymes degrade insulin before it can be effective 4. When Not to Give Insulin:Avoid giving insulin if the patient is hypoglycemic(blood sugar is low)to prevent a further drop.Intermediate-acting insulin may need to be held or clarified with the provider if combined with short-acting insulin without clear instructions.If in doubt about the insulin type or timing, always consult the provider5. Cloudy to Clear, Clear to Cloudy:When mixing insulin, draw up the clear insulin (short-acting)beforecloudy insulin (NPH). This order prevents contamination of the short-acting insulin with NPH 1
EXAM 2 PHARM NEED TO KNOWS ANSWERED6. Onset, Peak, and Duration of Insulin Types:Rapid-acting(e.g., Lispro): ONSET 15-30 mins, PEAK 30 mins - 3 hrs.,DURATION 3-5 hrs.Short-acting(e.g., Regular): ONSET 30 mins - 1 hr, PEAK 1-5 hrs, DURATION 6-10 hrs.Intermediate-acting(e.g., NPH): ONSET 1-2 hrs, PEAK 4-14 hrs, DURATION 14-24 hrs.Long-acting(e.g., Glargine): ONSET 1-4 hrs, NO PEAK, DURATION 24 hrs7. Signs of Hypoglycemia and Hyperglycemia:Hypoglycemia: Symptoms include sweating, shaking, headache, confusion, tachycardia, and cold/clammy skin.Hyperglycemia: Symptoms include increased thirst (polydipsia), frequent urination (polyuria), blurred vision, and fatigue2
EXAM 2 PHARM NEED TO KNOWS ANSWERED8. Metformin “Need-to-Knows”:Mechanism: Decreases hepatic glucose production and improves insulin sensitivity.Key Caution: It should be stopped 24 hours before imaging procedures with contrast and resumed 48 hours after to reduce the riskof lactic acidosisdue to kidney stress9. Medications for Hypothyroidism:Levothyroxineis the drug of choice, taken orally on an empty stomachto improve absorption. It increases T4 levels, helping regulate metabolism and body growth10. DI (Diabetes Insipidus) vs. SIADH:DI: Caused by ADH deficiency, resulting in excess water loss, high sodium levels, and dehydration. Treated with Desmopressin(DDAVP).SIADH: Excess ADH leads to water retention, low sodium, and fluid overload. Treated with fluid restrictionand sometimes medications like demeclocycline11. Addison’s Disease vs. Cushing’s Disease:Addison’s Disease: Due to adrenal insufficiency (low cortisol). Symptoms include weight loss, fatigue, and hyperpigmentation.3
EXAM 2 PHARM NEED TO KNOWS ANSWEREDCushing’s Disease: Caused by excessive cortisol. Symptoms include weight gain, moon face, high blood pressure, and central obesity12. Medications for Thyroid Disorders:Hypothyroid: Treated with Levothyroxine.Hyperthyroid (Graves’ disease): Treated with Propylthiouracil (PTU)or Methimazoleto reduce hormone synthesis. Radioactive iodine therapy or surgery may also be considered.Pre-surgery(e.g., subtotal or total thyroidectomy): Iodinemay be administered to reduce blood flow to the thyroid4
EXAM 2 PHARM NEED TO KNOWS ANSWERED13. Oral Antidiabetic Medications:Sulfonylureas: Stimulate pancreatic insulin production.Biguanides (Metformin): Reduce liver glucose production.Alpha-glucosidase inhibitors (e.g., Acarbose): Delay digestion of complex carbohydrates, reducing post-meal glucose spikes14. Diabetic Ketoacidosis (DKA):Signs: Elevated blood sugar, acidotic blood pH, Kussmaul respirations (rapid, deep breathing), fruity breath, and possible altered mental status.Compensatory Mechanism: The body uses rapid breathing to reduceacid levels by expelling CO215. Lab Values for Thyroid Disorders:Hypothyroidism: High TSH, low T3 and T4.5
EXAM 2 PHARM NEED TO KNOWS ANSWEREDHyperthyroidism: Low TSH, high T3 and T416. Foods High in Carbohydrates (Patient Education):Examples of complex carbs: Bread, rice, pasta, starchy vegetables like potatoes.Education: Patients should monitor portions of these foods to control blood sugar17. Thyrotoxicosis:Definition: An extreme form of hyperthyroidism that requires immediate treatment due to symptoms like high fever, rapid heart rate, and agitation18. Hypoglycemia Protocol:Typical Steps:oBlood sugar 65-70 mg/dL: Give 15g of fast-acting carbohydrates (juice) if the patient is alert.oBlood sugar 50-65 mg/dL: May require half an ampule of D50if the patient shows symptoms.oBlood sugar <50 mg/dL: Full ampule of D50 IV.Follow-Up:oStay with the patient and recheck blood glucose every 15 minutesuntil it’s above 70 mg/dL. Continue interventions per protocol until stable6