General Medical Management

Question 0

What is the upward limit of an IV push dose of insulin?

Answer 0

20 units

Question 1

What is the only insulin that can be given IV push?

Answer 1

Regular insulin

Question 2

What are three requirements when a patient is on an insulin drip protocol?

Answer 2

Remain NPO
Q1 DFS
Systematic monitoring of potassium level

Question 3

Is it acceptable for a patient with metabolic acidosis to be allowed to remain in Kussmaul respirations?

Answer 3

Yes. This is an acceptable compensatory mechanism.

Question 4

Which is more problematic in a DKA: patient febrile state or afebrile state?

Answer 4

An afebrile patient indicates that the body has used so much ATP that the immune system is no longer fighting the causal infection. This patient is at risk for death.

Question 5

What is the timeline for the development of DKA? HHNKS?

Answer 5

DKA = days
HHNKS = months

Question 6

How many ATP are produced from every molecule of glucose in the mitochondria?

Answer 6

36

Question 7

What is the hourly goal of blood glucose level reduction in the management of DKA?

Answer 7

50 points or mmol per hour. This will help the patient not to “crash”

Question 8

What is the initial multiplier for the BHCS IV insulin protocol?

Answer 8

.03

Question 9

What is an important assessment in the ongoing fluid resuscitation of an HHNKS patient?

Answer 9

Lung sounds. Comorbidities of a type 2 diabetic patient often make fluid resuscitation challenging.