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What's is the problem w/ a pt who has diabetes mellitus?
- answer-Blood Osmolality
What is incretin?
- answer-A hormone released in your gut that stimulates INSULIN secretion after a
meal.
Before administering insulin you should.....
- answer-1.) Check blood sugar
2.) Roll vials between hands instead of shaking them to mix suspensions
3.) Ensure correct storage of insulin vials
4.) Only use insulin syringes, calibrated in units to measure and give insulin
5.) Ensure correct timing of insulin dose with meals.
**If nurse is giving, it needs a second nurses check.
Why should you roll vial between hands vs shake?
- answer-Shaking makes BUBBLES so when you draw insulin up you will draw
bubbles up & administer the wrong amt.
How long can insulin be stored at room temperature?
- answer-30 days at room temp. **Remember not on your window seal or car in
Phx!
If the pt is unconscious administer _________________ or ________________.
- answer-D50W or glucagon IV
*Monitor pts blood glucose levels
Hypoglycemia: If the pt is _____________ administer an oral form of glucose such
as: ________________.
- answer-Conscious - oral forms include: glucose tablets, gel, corn syrup honey,
fruit juice, nondiet soft drink, crackers/ half a sandwich.
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, What's the "Rule of 15's (hypoglycemic) ?"
- answer-Give 15 grams of carbs, wait 15 minutes, retest blood glucose. If still
hypoglycemic give another 15 grams of carbs.
**Why do this? -- This avoids being OVER treated w/ food and spiking a HIGH
blood glucose kit.
Whats the correct method to give 2 types of insulin at once.
- answer-1.) Air in the cloudy.
2.) Air in the regular & draw up regular insulin
3.) Draw up intermediate/long (cloudy)
When you wear an insulin pump how much insulin is usually pumped/administered
through the planted cannula each hour? Hyperglycemia- Correction dosing?
- answer-0.4-2 units /hr as prescribed for 24 hrs
For Hyperglycemia -Correction dose 1 unit= 50mg decrease in blood sugars.
Pt teaching: What would you tell your pt to when they're home sick?
- answer-1.) Continue taking long-acting basal insulin
2.) Check your blood sugar more often.
3.) Use correction dosing with rapid acting insulin.
4.) Drink LOTS of FLUIDS
(Call doc if fever 105>, blood sugar about 250, or mod. to large ketones in urine.)
Alcohol can actually __________ blood sugars, but they need to count carbs for
fruit drinks/beer because that can increase blood sugar.
- answer-LOWER
If you eat 10-15 grams of carbs how many units should you give ?
- answer-1 unit
If someone appears drunk but they're not intoxicated what should you consider?
- answer-Hypoglycemic (*they may be very aggressive)
What kind of problems do diabetics have?
- answer-MICROVASCULAR (Eye, Kidney, Heart)
If pts BUN and Cr are too HIGH think.....
- answer-Possible dehydration
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