CNUR 300 Study Guide with 100% Complete Solutions
type 1 diabetes mellitus
lack of insulin production of defective insulin
- body does not make insulin
type 2 diabetes mellitus
caused by insulin deficiency and insulin resistance
- more complex, insulin resistance (body not using insulin how it should be
treatment type 1
insulin therapy
treatment type 2
lifestyle modifications
oral drug therapy
insulin may be needed
numbers at a glance diabetes
A1C less than 7%
blood glucose before meals 70-130
blood glucose 2 hours after meals less than 180
blood glucose bedtime 110-150
insulin
functions as a substitute for the endogenous hormone
- restores ability to metabolize carbs, fats, and proteins, store glucose in the liver, convert
glycogen to fat stores
rapid acting insulin
,insulin lispro and Novolog
- can be given SQ not IV
- pt must eat a meal after injection
- more rapid onset of action (5-15 minutes)
- peak: 30-90 minutes
- duration 3-5 hours
short acting insulins
regular insulin (humulin R)
- IV bolus, IV infusion, IM, and SQ
- onset 30-60 min
- peak 2-3 hours
- duration 5-8 hours
immediate acting insulins
insulin isophane suspension (NPH)
- CLOUDY
- combined with regular often
- onset 2-4 hours
- peak 4-10 hours
- duration 10-16
when drawing from 2 insulins draw
clear to cloudy
long acting insulin (g)
insulin glargine
- constant level of insulin in the body
- usually dosed once daily
- can be dosed every 12
, - referred to as basal insulin
- onset 2-4 hours
- peak: none
- duration: 24 hours
long acting insulin (d)
insulin detemir
- dose dependent
- lower doses require twice daily
- onset 3-8
- peak - none
- duration 6-24
- approved for prenancy
The nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just
after the injection, the dietary department calls to inform the patient care unit that breakfast
trays will be 45 minutes late. What will the nurse do next?
A.Give the patient food, such as cereal and skim milk, and juice.
Rationale: Lispro insulin's onset of action is 15 minutes. It is essential that a patient with DM eat
a meal after injection. Otherwise, profound hypoglycemia may result.
A woman who has type 2 DM is now pregnant. She wants to know whether to take her oral
antidiabetic medication. What instructions will she receive?
A.She will be switched to insulin therapy while she is pregnant.
Rationale: Oral antidiabetic medications are generally not recommended for pregnant patients
because of a lack of firm safety data. Insulin therapy is the currently recommended drug
therapy for pregnant women.
basal-bolus insulin dosing
type 1 diabetes mellitus
lack of insulin production of defective insulin
- body does not make insulin
type 2 diabetes mellitus
caused by insulin deficiency and insulin resistance
- more complex, insulin resistance (body not using insulin how it should be
treatment type 1
insulin therapy
treatment type 2
lifestyle modifications
oral drug therapy
insulin may be needed
numbers at a glance diabetes
A1C less than 7%
blood glucose before meals 70-130
blood glucose 2 hours after meals less than 180
blood glucose bedtime 110-150
insulin
functions as a substitute for the endogenous hormone
- restores ability to metabolize carbs, fats, and proteins, store glucose in the liver, convert
glycogen to fat stores
rapid acting insulin
,insulin lispro and Novolog
- can be given SQ not IV
- pt must eat a meal after injection
- more rapid onset of action (5-15 minutes)
- peak: 30-90 minutes
- duration 3-5 hours
short acting insulins
regular insulin (humulin R)
- IV bolus, IV infusion, IM, and SQ
- onset 30-60 min
- peak 2-3 hours
- duration 5-8 hours
immediate acting insulins
insulin isophane suspension (NPH)
- CLOUDY
- combined with regular often
- onset 2-4 hours
- peak 4-10 hours
- duration 10-16
when drawing from 2 insulins draw
clear to cloudy
long acting insulin (g)
insulin glargine
- constant level of insulin in the body
- usually dosed once daily
- can be dosed every 12
, - referred to as basal insulin
- onset 2-4 hours
- peak: none
- duration: 24 hours
long acting insulin (d)
insulin detemir
- dose dependent
- lower doses require twice daily
- onset 3-8
- peak - none
- duration 6-24
- approved for prenancy
The nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just
after the injection, the dietary department calls to inform the patient care unit that breakfast
trays will be 45 minutes late. What will the nurse do next?
A.Give the patient food, such as cereal and skim milk, and juice.
Rationale: Lispro insulin's onset of action is 15 minutes. It is essential that a patient with DM eat
a meal after injection. Otherwise, profound hypoglycemia may result.
A woman who has type 2 DM is now pregnant. She wants to know whether to take her oral
antidiabetic medication. What instructions will she receive?
A.She will be switched to insulin therapy while she is pregnant.
Rationale: Oral antidiabetic medications are generally not recommended for pregnant patients
because of a lack of firm safety data. Insulin therapy is the currently recommended drug
therapy for pregnant women.
basal-bolus insulin dosing
