DM 3

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  1. Glucose monitoring
    • Self monitoring of blood glucose (SMBG)
    • - proper technique
    • - store equipment properly
    • - 2-4x day if taking insulin
    • - less frequently if not taking insulin
    • - before and after exercise- esp type 1
    • - all pts: hypo/hyperglycemic
    • Whole blood tends to run higher than venous blood
  2. Review agents for DM
    • insulin and oral
    • know onset, peak, duration humalog (lispro), regular insulin, lantus
    • injection administration and techniques
    • oral agents: 2nd generation agents (Glucotrol, biguanides (glucophage), thiazolinediones (actos): MOA and teaching
  3. Insulin
    • can be used with type 1 and 2
    • many different preparation
    • alone or in combo
    • goal is consistent glu levels
    • educate pt about administration, adjustment to use, side effects
  4. Types of Insulin
    • Rapid acting, humalog (lispro), onset 15 min, peak 1hr, duration 2-4 hr
    • short acting, regular R novolin, onset 30 min-1 hr, peak 2-4 hr, duration 4-6 hr
    • intermediate acting, NPH (humlin) N, onset 3-4 hrs, peak 4-12 hr, duration 16-20 hr
    • long acting (very), Lantus, onset 1 hr, peak none, duration 24 hr
  5. Insulin guidelines
    • eat within 15 mins with rapid acting
    • eat within 30 mins with short acting
    • **** only Regular insulin can be used IV
    • NPH may be given 2x/day
    • assess onset and peaks
    • never mix another insulin with lantus
    • lantus any time of day, but at the same time everyday
    • *** review insulin: pre- op, sick days, diets (NPO, clear liquid),
    • look at pharm
  6. Insulin
    administration storage
    • Rotate site
    • - prevent lipodystrophy
    • - abdomen is preferred site for pts
    • Stable at room temp x 1 month
    • refrigerate extra
    • " roll" bottle of NPH
    • protect from sunlight
  7. Types of insulin
    • traditional injections
    • insulin pens
    • jet injections
    • insulin pump
  8. Nursing management
    • long term management
    • avoidance of potential complication
    • Nursing dx
    • ineffective self- health management
    • imbalance nutrition: more than body requirement
    • risk for injury
    • risk for peripheral neurovascular dysfunction
  9. Nursing management 2
    • Problem solving/healthy coping
    • - assessment, including pt perceptions and attitudes, lifestyle preferences, coping stragtegies
    • - eating out, vacations, etc
    • - meds, infection, physical or emotional stress may increase glucose
    • - accommodations for visual impairment
    • - when to contact PCP
    • - lifelong learning
  10. Nursing management 3
    • reducing risks:
    • foot care
    • eye care
    • skin care
    • oral hygiene
    • BP control
    • lipid control
    • medical alert bracelet
  11. nursing consideration
    for humalog
    • food ready right away
    • check BS within a 1hr
    • monitor for hypoglycemia

    correct insulin, dosage, syringe
Author
ID
312577
Card Set
DM 3
Description
high bs
Updated
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