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Exam (elaborations)

Nurs 485 Exam Part B Questions With Complete Answers

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Nurs 485 Exam Part B Questions With Complete Answers...

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Nurs 485 Exam Part B Questions With
Complete Answers

Insulin: ________ hormone
Synthesized in _____ cells (Langerhans) - ANSWER Pancreatic; Beta

Insulin action:
Glucose cellular _______
Promotes storage formation (______ synthesis, _______ synthesis, _______
synthesis) - ANSWER uptake; glycogen; triglyceride; protein

Insulin is a hormone your pancreas makes to ______ blood glucose, or sugar. If
you have diabetes, your pancreas either doesn't make enough insulin or your
body doesn't respond well to it.
The pancreas responds by producing insulin, which allows glucose to ______ the
body's cells to provide energy. Store excess glucose for energy. After you eat —
when insulin levels are high — excess glucose is stored in the liver in the form of
_______ - ANSWER lower; enter; glycogen

Glucagon: synthesized in _______ cells = opposite of Insulin - ANSWER Alpha

Glucagon:
Promotes mobilization of stores: glycogenolysis (______ breakdown);_________
(amino acid breakdown into glucose); ________ (triglyceride breakdown)
Triggered by _____ plasma glucose levels (between meals; hypoglycemia) =>
mobilize stores and replenish blood glucose for cellular use - ANSWER
glycogen; gluconeogenesis; lipolysis; low

High blood glucose --> pancreas releases _______ --> cells take ____ glucose
from blood and liver produces _________ --> blood glucose falls - ANSWER
insulin; up; glycogen

Low blood glucose --> pancreas releases _______ --> liver breaks down _________
--> blood glucose rises - ANSWER glucagon; glycogen

Insulin inhibition: ________ (D cell produced) - ANSWER Somatostatin

Diabetes Mellitus Type 1

,Type 1A: ________ + ____________ (or big time growth due to hormone shift)(e.g.
infection) => immune reaction to beta cell antigens = autoimmune - ANSWER
genetic predisposition + triggering event

Diabetes Mellitus Type 1
Type 1B: __________, rare - ANSWER idiopathic (familial)

Diabetes Mellitus Type 1 = total destruction of _____ cells: insulin? ___________ -
ANSWER beta ; IDDM (insulin dependent)

Diabetes Mellitus Type 1:
Diagnosis: usually pre-____ yrs of age (toddlers; teens)
Tx: _______
No Tx: _________ = death
Ketones → acidic → decreased pH → ________ - ANSWER 30; insulin ; diabetic
ketoacidosis; metabolic acidosis

Diabetes mellitus
Dx (diagnosis): fasting glucose >___ mmol/L (normal=<6, 4-8 feeling great)
Leading cause of :
______ (retinopathy)
End-stage ______ failure (nephropathy)
Non-traumatic _______ (neuropathy)
________ disease (cardiac implications) - ANSWER 7; Blindness; renal;
amputation; Cardiovascular

Tx with Insulin:
Goal:
Restore ______ glucose patterns
Minimizing risk of ________ - ANSWER normal; hypoglycemia

4 insulin preparation types: - ANSWER 1) Rapid acting
2) Long acting
3) Short acting ('regular')
4) Intermediate acting

Administration
Route: (note: ____ utilized in critically ill patients)
_____
Needle Injections
Portable Pen Injectors
Insulin pumps - basal & bolus delivery
7 rights:
Dose double checked = ___ RNs
Measured in 'units' = U
Patient learning and education !!! - ANSWER IV; SC; 2

, 1) Rapid acting Insulin
Onset: ______
Peak: ______
Duration: _______ - ANSWER 10-15 minutes; 1-2 hr; 3-5 hrs

Rapid acting Insulin:
Ideal for: ______-time bolus; pt eats right away! (food tray _______!!); in insulin
pumps; not ____ (check what type of carbs and make sure they actually ate) -
ANSWER meal; ready; IV

Rapid acting Insulin - ANSWER Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra)

Another rapid acting insulin:
Fiasp (______) - onset: ___ min
=> improved mealtime control; admin. immediately prior or during meal -
ANSWER Aspart; 4

'Rapid acting' insulin in pumps:
Utilized to achieve ______
as per insulin/carbohydrate ratio
*glucose levels pre-meal
glucose levels 1 hr post
• and to customize ______ insulin requirements
Slow infusion of rapid acting insulin over 24 hrs
Careful monitoring
Endocrinologist appointments ongoing
Ongoing management - ANSWER boluses; basal;

Long acting Insulin
Onset: ______
Plateaus for: up to _______ - ANSWER 90 min; 24 hrs

Long acting Insulin
Ideal for: _________; admin. _____ x daily; MUST have separate syringe for
injection (contamination decreases efficacy ++++); never ____ - ANSWER
background; 1-2; IV

Long acting Insulin Meds - ANSWER Detemir
Glargine

Ultra-long acting insulin >____hrs
__________ - ANSWER 30; Dugludec (Tresiba)

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