General Pharmacology Notes – Drug Actions, Administration & Nursing Considerations

Pharmacology: Chapter
35: Drugs Used to Treat
Diabetes Mellitus


A patient received the evening dose of Lispro subcutaneously at 16:30 PM. What time will
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symptoms of hypoglycemia likely occur?
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a. 19:00B B




b. 18:30B B




c. 01:30
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d. 06:00 - CORRECT ANSWER-b. 18:30
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The most rapid-acting insulin, Lispro, peaks within 1 to 2 hours after administration. The peak
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time of insulin is when patients would most likely exhibit symptoms of hypoglycemia,
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particularly if they have inadequate dietary intake. The time of 19:00 would be past the peak of
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action and after signs of hypoglycemia would have appeared. The times of 01:30 and 06:00 are
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long after the peak of action and the time when signs of hypoglycemia would have appeared.
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It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining
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Bof a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a
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Bone touch glucose reads 50 mg/dL. Which action is most important for the nurse to take?
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, a. Have the patient eat a snack and drink milk.
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b. Administer glucagon subcutaneously.
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c. Call the bronchoscopy room to follow up with the delay.
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d. Obtain an A1c test. - CORRECT ANSWER-b. Administer glucagon subcutaneously.
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Irritability, nervousness, headache, tremors, dizziness, apprehension, sweating, cold and clammy
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Bskin, and hunger are symptoms of hypoglycemia. The patient has not eaten since the prior day. A
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Bblood glucose of 50 mg/dL is true hypoglycemia and needs to be dealt with immediately.
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BGlucagon is preferred over PO intake, given that an endoscopy is scheduled. Having the patient
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Beat a snack and drink milk, calling the bronchoscopy room, and obtaining an A1c test are not
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Bappropriate responses. B




After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro
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and 8 units of NPH. Which action will the nurse take to administer these medications?
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a. Draw up each insulin in separate syringes and administer two injections.
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b. Draw up the NPH first and then the Lispro using the same syringe.
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c. Administer the Lispro before the meal and the NPH after the meal.
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d. Draw up the Lispro first and then the NPH using the same syringe. - CORRECT ANSWER-d.
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Draw up the Lispro first and then the NPH using the same syringe.
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Lispro, an insulin analogue, is the most rapid-acting insulin. Insulin analogues are compatible
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with intermediate- (NPH) or long-acting insulin. When combining two types of insulin, the short-
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acting insulin is drawn up before the intermediate-acting insulin. There is no reason to administer
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a second injection. The long-acting insulin is drawn up last when mixing. Insulin is to be
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administered before meals.
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A patient with type 2 diabetes mellitus, which was previously controlled with an oral antidiabetic
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agent, is hospitalized for treatment of a leg ulcer. The healthcare provider has ordered sliding
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