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Insulins are used for which Diabetes Mellitus?
Type 1 & Type 2
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Which Insulins are Rapid-acting?
- Lispro (Humalog)
- Aspart (Novalog)
- Glulisine (Apidra)
CLEAR
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Name the Short-acting Insulins.
Regular insulin (Humulin R)
CLEAR
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What are the Intermediate-acting Insulins?
- Isophane suspension (NPH, Humulin N)
- Zinc Suspension (Lente, Humulin L)
- CLOUDY
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Which insulin is Long-acting & what is it's onset & peak?
- Glargine (Lantus) CLEAR
- Onset: 1hr
- Peak: NONE
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What are the insulin mixtures that are fast & intermediate-acting?
- NPH 70 & Regular 30 (Humulin 70/30)
- NPH 50 & Regular 50 (Humulin 50/50)
- Lispro prtamin susp. & lispro (Humalog mix 75/25)
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For the rapid-acting insulins Lispro (Humalog), Aspart (Novalog) & Glulisine (Apidra), what are the Onset & Peak?
- Onset: 5-15min
- Peak: 30-90min
- *clear liquid
- *food right in front of pt as given SQ
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For the Short-acting insulins Regular (R), Humulin R, & Novolin R, what is the onset & peak of action?
- *clear liquid
- *Only the R's can be given IV if needed
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For the Insulins Isophane insulin susp. (NPH): Humulin N & Novolin N, as well as Insulin Zinc susp. (Lente): Humulin N & Novolin N; what are the onset & peak?
- Onset: 1-2hr
- Peaks: 6-12hr
- CLOUDY
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With Basal Insulins (long-acting), like Lantus. What are the onset & peak? What what can they be mixed with?
- Onset: 1hr
- Peak: NONE
- Can NOT be mixed w/any other insulin!!!
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Explain what "Peak" means with admin of insulin.
When the pt is most likely to experience hypoglycemia
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What are the combination insulins that have ratios of NPH & regular mixed together?
- Humulin 70/30
- Novolin 70/30
- Humulin 30/70
- Humulin 50/50
- Humalog & Novalog mixes (75/25)
- **CLOUDY
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What are the do's & don'ts of insulin storage?
- At room temp: 1month
- In fridge: 3months
- Remove from fridge 30min before use
- unopened vials stored in fridge
- DO NOT FREEZE
- No direct sunlight/high temps
- Prefilled syringes in fridge
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What types of insulin delivery systems are there?
- Jet injectors
- Vials
- Pens
- Pumps
- *Inhalation: Exubera
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What are the common s/e of Insulins?
- Hypoglycemia
- Wt gain
- Insulin shock
- Local itching, swelling, erythema at site
- Lipodystrophy
- Somogyi effect (hypo 2-4am)
- Dawn phenom: hyper AM
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What are the s/s of Hypoglycemia?
- HA, dizziness, confusion, slurred speech
- Nervousness, anxiety, agitation
- Tremors, Ataxia, sweating, tachycardic, seizures
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What are the s/s of Hyperglycemia?
Extreme thirst, dry mucous membranes, poor skin turgor, polyuria, fruity breath, fatique, tachy, Kussmaul respirations
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What are the nursing interventions for Insulin Administration?
- **BLOOD GLUCOSE LEVELS
- Client to report s/s of hypo/hyperglycemia
- Enc. diet compliance, insulin & exercise
- Medic alert bracelet
- How to check BS
- How to admin insulin
- **call MD for NPO dosing if needed
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Special client teaching for Diabetics & insulin dependents?
- During peak monitor for hypoglycemia
- Avoid alcohol->causes hypo
- If ill, take meds as usual ->monitor BS often
- Call MD if BS consistently ^250 or can't stop V/D
- Carry ID, wear medic alert bracelet
- Carry quick sugar for hypo moments
- Take BS before driving if feeling hypo/hyper
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What would you give a client with insulin induced hypoglycemia?
Glucagon
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What is Glucagon?
- Hyperglycemic hormone secreted by alpha cells of the islets of Langerhans in the pancreas
- Stimulates breakdown of stored glycogen to glucose in liver
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