AlinaDustman Preview

Nursing - Diabetes Mellitus ScienceMedicine ajd_18 Save

Nursing: Diabetes

52 terms AlinaDustmanPreview Nursing Diabetes Mellitus 167 terms devinedreamPreview Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Diabet 23 terms Isla Diabetes Mellitus DM Type 1 DM Type 2 Insulins

Rapid Acting Insulin • Lispro (Humalog), Aspart (NovoLog), Glulisine (Apidra) • Onset 10-30m • Peak 0.5-3 • Duration 3-5 • Give 0-15m before meals.Short Acting Insulin (Regular) • Novolin-R, Humulin-R, ReliOn-R • Onset 0.5-1 • Peak 2-5 • Duration 5-8 • Give 30-45m before meals.Intermediate Acting Insulin (NPH) • Novolin-N, Humulin-N, ReliOn-N • Onset 1.5-4 • Peak 4-12 • Duration 12-18 • If given in evening then give bedtime snack.Long Acting Insulin • Degludec (Tresiba), Detemir (Levemir), Glargine (Lantus, Trujeo) • Onset 0.8-4 • Peak undefined • Duration 16-24 • Given either morning or bedtime.Sulfonylureas • Increases release of insulin from pancreas.• Increases response to insulin.

• Names: glimepiride, glipizide, glyburide

• Test FSBS first.

• Assess for: hypoglycemia, GI upset, skin rash/itching, weight gain.

• Take same time daily, 30 mins before meal.Biguanides • Makes existing insulin more effective.

• Names: metformin

• Take same time daily. Monitor BG levels.

• Assess for: rapid breathing, drowsiness, malaise.

• DC 48hrs before radiocontrast dye procedures.

Alpha Glucoside Inhibitors • Slows absorption of carbs.

• Names: acarbose, miglitol

• Take with first bite of meal.

• Assess for: gas, diarrhea, GI upset.

Meglitinides • Stimulates pancreas to secret insulin.

• Names: repaglinide, nateglinide

• Take 30 mins before meals.• Monitor for hypoglycemia and weight gain.TZDs • Increases insulin sensitivity on liver, muscle, and fat cells.• Improves lipid levels.

• Names: rosiglitazone, pioglitazone

• Assess for: anorexia, jaundice, dark urine, and chest pains.

DDP-4 Inhibitors • Allows incretin hormones to produce more insulin without being activated.

• Names: sitagliptin, vildagliptin

• Assess for s/s of urinary tract infections and s/s of upper respiratory infections.HgbA1C Testing • Provides an estimate of average blood sugar over the past 2-3 months.

• Normal: 4.5-6.5%

• Goal should be 7% to prevent hypoglycemia due to medications.• 5.7-6.4% can indicate pre-diabetes.FBG (Fasting Blood Glucose) This test measures the level of glucose in the blood after fasting for at least 8 hours.• 70-99 mg/dL (3.9-5.5 mmol/L) = Normal • 100-125 mg/dL (5.6-6.9 mmol/L) = Prediabetes • 126 mg/dL (7.0 mmol/L) and above = Diabetes If above 126 must be done repeatedly for confirmation.

Urine Test for Ketones • Patient will void and discard urine sample.• Give full glass of water.• 30 mins later collect a urine sample.• Place AcidTest tablet on white paper towel • Place 1 drop of urine on tablet and wait 30 secs.• If tablet turns any shade of purple the urine is positive for ketones.Hypoglycemia Hypoglycemia s/s • confusion • irritability • diaphoresis • tremors • hunger • weakness • can mimic alcohol intoxication.

• untreated s/s: LOC, seizures, coma, death.

Hypoglycemia tx • Monitor BG levels.

• If alert: 15-20g simple carb (4-6oz fruit juice, soft drink)

• If unconscious: administre 1 mg glucagon IM or SQ (20-50 ml of 50% dextrose IV push) Diabetic Ketoacidosis (DKA)