a pt is experiencing hypoglycemia as indicated by their blood sugar reading of 45 mg/dl. which should the nurse give to the pt?
1) 1 tsp of honey
2) 6 oz of apple juice
3) 4 oz of skim milk
4) one or two glucose tablets
6 oz of apple juice. the others are dont have enought carbs in them.
This type of insulin has an onset of 70 minutes, has no peak and has a duration of 24 hours
Insulin glargine (Lantus)
This insulin has an onset of 60 minutes, peaks in 1 to 5 hours, and lasts up to 10 hours.
Regular insulin ( Humulin R, Novolin R)
This insulin has an onset of 60 to 120 minutes, peaks in 6 to 14 hours, and has a duration of 16 to 24 hours
Neutral protamine hagedorn (NPH) insulin
This insulin has a slow onset, peaks between 12 to 24 hours, and has a duration that varies with the dosage
Insulin detemir (Levemir)
When injecting insulin, what can the pt do to reduce pain?
keep the injection pen/ syringe at room temp for a few minutes
True of false. Inserting a needle slowly, reduces pain for the client
False. If inserting a needle to slow, it was cause more pain for the client
According to ATI what is the acceptable range for a fasting blood sugar
70 and 105 mg/dl
would a glucose of 120 mg/dl be an acceptable blood sugar for a random (casual) test?
yes
The risk for diabetic ketoacidosis (DKA) increases with the use of a pump because?
The tubing could become occluded.
A complication of diabetes that occurs when the body cannot use sugar (glucose) as a fuel source
because the body has no insulin or not enough insulin, and fat is used instead
Diabetic Ketoacidosis (DKA)
What kind of insulin does a insulin pump use?
Rapid acting (such as novelog)
What are three rapid acting insulins?
Apidra, Humalog, Novolog
When testing blood sugar, how do you transfer a pt's blood to the test strip?
Hold the test strip next to the blood on the patient's fingertip
How does Biguanide which is metformin (Glucophage) help a person with type 2 diabetes?
It reduces hepatic glucose production while increasing insulin actino on muscle glucose uptake
These type of type 2 diabetic medicines work by increasing insulin secretion by the beta cells of the pancreas
Sulfonylureas, and Meglitinides (glinides)
This type of diabetic medicine increases the cellular response to insulin by decreasing insulin resistance
Thiazolidinediones (Glitazones) WTF?
This type of diabetic medication works by delaying carbohydrate digestion.
Alpha- Glucosidase inhibitors
This type of diabetic medication works by augmenting naturally occurring incretin hormones, which promote the release of insulin and decrease the secretion of glucagon
Gliptins
True of false. Before a specimen collectio, the nurse need to irrigate the wound with an antispetic solution.
Fasle. wounds should be cleasned with a normal saline solution or sterile water.
True of False. Rotating a swab in the center (area of drainage) of the wound base to collect drainage is the appropriate technique for collecting a wound culture.
True.
when taking a blood culture from a pt, what should the nurse do to help with the procedure before puncturing the arm?
Rub the pt's arm at teh selected site prior to venipuncture. this can help dialte the vein
Is it ok to puncture a slected vein while the antiseptic solution is still visible on the skin?
NO. antiseptic solution used to cleanse a puncture site must air dry completely to ensure effective antimicrobial action.
When testing for occult blood, the nurse tells the pt to collect how many specimens for testing while at home?
3 specimens must be taken from 3 separate, consecutive bowel movements
True of False. The specimen card testing for occult bleeding should be refrigerated after obtaining a fecal sample
False.
When obtaining a midsream urine specimen, what should the nurse instruct the pt to do?
Have the patient urinate a small amount of unrine before starting the collection.
for a urine specimen, how much urine is required?
30 to 60 ml
The pt should cleanse the perineal area from which way?
back to front
Midstream urin specimens must be collected in what kind of cup?
a sterile cup
what is the collection container for a urine specimen kept on until it's delivered to the lab?
On ice
when collecting a 24 hour urine specimen from a pt, what # specimen is collected?
the 2cnd. After the pt goes the first time within the 24 hour interval, the second specimen is collected
What helps blood flow to the fingers for a pt who has difficulty getting blood to come after a fingerstick?
heat. Wrapping a finger in warmth would help
True of False. A clean cup is appropriate for a routine urine analysis
True.
what type of urine test is required for a urine creatinine clearance?
A timed urine collection
What can give a false positive for occult blood and should be withheld from being eatin at least a few days prior of the testing period?
Poultry, seafood, Read meat and some raw veges
What is range for specific gravity?
1.0053 to 1.030.
During dehyrdration, will a pt have a higher or lower Specific gravity?
higher
what is normal ph of the urine?
between 4.6 to 8.0
what is the normal ph of blood?
7.35 to 7.45
what is the normal range for WBC in the urine?
0 to 4,000/mm3
A wbc count of 8,000/mm3 found in the urine would be a good indicator for what?
A UTI
These types of port is designed for long term therapy such as pts receiving chemotherapy or parenteral nutrition.
A tunneled central catheter, implanted port, and peripherally inserted central catheter
This type of central catheter is ideal for emergency situations where short term central venous access is required for multiple therapies.
a nontunneled percutaneous central catheter.
A nurse is going to take a blood sample from a patient who has a triple-lumen central catheter in place for multiple therapies. what should the nurse do before taking blood?
Turn off the distal infusions for 1 to 5 minutes before obtaining the blood sample.
True of false. the lumen with the largest diameter is the best one to withdraw a blood sample from/
True
The amount of aspirate to discard before collecting a blood sample is generally no more than ?
10 ml
When flushing a central venous catheter, what size syringe should the nurse use to prevent catheter rupture
10 ml or larger.
For a nurse suspects an air embolism with a client who has a central venous catheter. what position should the patient be repostioned in?
On his left side in Trendelenburg position
For a person who requires long term central venous access who does water aerobics, which of the following central venous devices is the best choice for the pt?
1) A tunneled central catheter
2) an implanted port
3) a peripherally inserted central cather
2) implanted port. the device lies beneath the skin so the pt can be immersed in water.
When flushing a central venous catheter/ PICC line, what type of techniquie is recommended?
A pulsatile (push-stop-push-stop) technique. this helps create turbulance that helps clear any sediment in the line
PICC lines that are not in use are flushed how often?
Once per week
For PICC flushes a volume of at least _ is appropriate for most foutine flushes
5ml
What is heparin used for?
Used to treat or prevent blood clots
would it be approprate to flush a PICC line with a non-heparinized saline solution ?
yes. Blood does not back up into the catheter's lumen (where it could clot) so there is need for the heparin
for a pt with a central venous access device, what measure should the nurse use to specifically prevent lumen occlusion?
clamping the extension tubing while removing a syringe from the infection cap. this type of technique prevents the reflux of blood back into the catheter
What technique is used to prevent catheter dislodgement?
Removing the dressing from the insertion site slowly and carefully
What technique is used to help prevent an air embolism?
have the pt lie flat when changing administration sets or injection caps
For the insertion of a primed needle into a pt's implanted port, what angle should the needle be?
45 degrees
What type of needle should an implanted port be accessed with?
noncoring (Huber) needle.
After inserting the needle for a pt receiving parenteral nutrition via his implanted port, the nurse anchors the needle. What is the next thing she should do?
Cover the port and the needle with a transparent dressing.
