BSN 7000 FINAL EXAM: CASE STUDY QUESTIONS & VERIFIED
ANSWERS (26/27) ASSURED SUCCESS
What's the concern with exenatide?
It's prescribed for sc 2x at home, the patient requires education for
proper management
What are the important symptoms of case study 4 (devon)?
Recent diagnosis of type 1 diabetes, bg of 32 mmol/l, confusion, soft
bp, febrile
Dka
Body burns fat for energy creating ketones increasing the acid levels
in the body (low ph) caused by improper insulin adherence for type 1
diabetes, infection
Signs and symptoms of type 1 diabetes
High blood glucose, ketones, acidosis, dehydration, kussmaul
respirations, acetone breath, abdominal pain, n/v
Treatment for dka
1. Treat dehydration first with iv fluids (watch for icp, seizure
precautions)
P a g e 1 | 22
,2. Slowly lower bg with iv regular insulin
3. Hourly bg levels
4. Cardiac monitoring
5. Monitor electrolyte levels
6. Education required about new type 1 diabetes before discharge
Type 1 diabetes
No insulin production caused by genetic autoimmune reaction
Priority problems for case study 4 (devon)
Dka related to new diagnosis of type 1 diabetes evidenced by high
blood glucose and lab work showing metabolic acidosis and kussmaul
breathing
Rapid acting insulin
Lispro (humalog)
Aspart (novolog)
Glulisine (apidra)
When should you eat with rapid acting insulin?
Same time as injection
P a g e 2 | 22
, Short acting insulin
Regular (humulin r, novolin r)
When should you eat with short acting insulin?
Within an hour
What insulin can be used with iv?
Regular insulin
What colour is short acting insulin?
Clear (draw up first)
What colour is intermediate insulin?
Cloudy (draw up second)
Intermediate insulin
Nph (humulin n, novolin n)
P a g e 3 | 22
ANSWERS (26/27) ASSURED SUCCESS
What's the concern with exenatide?
It's prescribed for sc 2x at home, the patient requires education for
proper management
What are the important symptoms of case study 4 (devon)?
Recent diagnosis of type 1 diabetes, bg of 32 mmol/l, confusion, soft
bp, febrile
Dka
Body burns fat for energy creating ketones increasing the acid levels
in the body (low ph) caused by improper insulin adherence for type 1
diabetes, infection
Signs and symptoms of type 1 diabetes
High blood glucose, ketones, acidosis, dehydration, kussmaul
respirations, acetone breath, abdominal pain, n/v
Treatment for dka
1. Treat dehydration first with iv fluids (watch for icp, seizure
precautions)
P a g e 1 | 22
,2. Slowly lower bg with iv regular insulin
3. Hourly bg levels
4. Cardiac monitoring
5. Monitor electrolyte levels
6. Education required about new type 1 diabetes before discharge
Type 1 diabetes
No insulin production caused by genetic autoimmune reaction
Priority problems for case study 4 (devon)
Dka related to new diagnosis of type 1 diabetes evidenced by high
blood glucose and lab work showing metabolic acidosis and kussmaul
breathing
Rapid acting insulin
Lispro (humalog)
Aspart (novolog)
Glulisine (apidra)
When should you eat with rapid acting insulin?
Same time as injection
P a g e 2 | 22
, Short acting insulin
Regular (humulin r, novolin r)
When should you eat with short acting insulin?
Within an hour
What insulin can be used with iv?
Regular insulin
What colour is short acting insulin?
Clear (draw up first)
What colour is intermediate insulin?
Cloudy (draw up second)
Intermediate insulin
Nph (humulin n, novolin n)
P a g e 3 | 22
