Diabetes

Question 1

metformin (Glucophage): Class

Answer 1

Biguanides - first line monotherapy

Question 2

metformin (Glucophage): Use

Answer 2

Initial drug used to treat type II diabetes

Question 3

metformin (Glucophage): EPA

Answer 3

Reduces the production of glucose by the liver, decreases absorption of glucose from the intestines & increases sensitivity of insulin receptors in tissues.

Question 4

metformin (Glucophage): ADRs

Answer 4

Lactic acidosis, N/V/D, metallic taste, BLACK BOX WARNING

Question 5

metformin (Glucophage): BLACK BOX WARNING

Answer 5

Risk for potentially fatal lactic acidosis for people with a history because increases production of lactate

Question 6

metformin (Glucophage): contraindications

Answer 6

Not given during severe illness, surgery, or hospitalization
Pregnancy
Renal and hepatic impairment
Hx of lactic acidosis
ETOH

Question 7

metformin (Glucophage): RN Interventions

Answer 7

take with meals, do not stop taking without consulting provider, avoid ETOH, CAN NOT be taken if client is having imaging done because it can cause kidney injury, hold 48 hrs before and after contrast imagery

Question 8

glipizide (Glucotrol): Class

Answer 8

Sulfonylureas

Question 9

glipizide (Glucotrol): Use

Answer 9

Used in combination with diet to lower blood sugar levels in patients with type II diabetes

Question 10

glipizide (Glucotrol): EPA

Answer 10

Stimulates pancreatic beta cells to produce more insulin, therefore increasing secretion of insulin.

Question 11

glipizide (Glucotrol): ADR

Answer 11

hypoglycemia

Question 12

glipizide (Glucotrol): contraindications

Answer 12

Sulfa allergy-should not take
Pregnancy
Renal or hepatic dysfunction

Question 13

glipizide (Glucotrol): RN Interventions

Answer 13

take 30 minutes before meals, Not given during severe illness, surgery, hospitalization or pregnancy (need to take insulin instead to control blood sugars)

Question 14

repaglinide (Prandin): classification

Answer 14

Meglitinides

Question 15

repaglinide (Prandin): EPA

Answer 15

similar to sulfonylureas, stimulate section of insulin

Question 16

pioglitazone (Actos): Classification

Answer 16

Thiazolidinediones (TZDs)

Question 17

pioglitazone (Actos): EPA

Answer 17

reduces insulin resistance of tissue

Question 18

acarbose (Precose): Classification

Answer 18

Alpha-glucosidase inhibitors

Question 19

acarbose (Precose): EPA

Answer 19

blocks/delays digestion/absorption of carbs

Question 20

sitagliptin (Januvia): Classification

Answer 20

Gliptins

Question 21

sitagliptin (Januvia): EPA

Answer 21

Inhibits inactivation of incretin hormones (and thus increases insulin secretion)

Question 22

Regular insulin: classification

Answer 22

Short-Acting Insulin

Question 23

Regular insulin: Use

Answer 23

To control blood sugar in patients with type I diabetes or in patients with type II diabetes that could not get control with diet, exercise and oral agents

Question 24

Regular insulin: EPA and onset

Answer 24

Short-acting insulin with an onset of 30-60 minutes. Replaces endogenous insulin and has the same effect as the pancreatic hormone

Question 25

What is specific about regular insulin administration?

Answer 25

It is the only insulin that can be given IV

Question 26

regular insulin: ADR

Answer 26

hypoglycemia

Question 27

regular insulin: contraindications

Answer 27

hypoglycemia, people with renal disease the dose will need to be lowered

Question 28

lispro insulin (Humalog): classification

Answer 28

Rapid-Acting insulin (Meal-time insulin)

Question 29

lispro insulin (Humalog): other medications

Answer 29

aspart (Novolog)

Question 30

lispro insulin (Humalog): Use

Answer 30

Rapid-acting insulin that is given with meals or to correct a high blood glucose level. Can be used in patients with type I or type II diabetes

Question 31

lispro insulin (Humalog): EPA and onset

Answer 31

onset is quick, about 15 minutes

Question 32

lispro insulin (Humalog): ADR

Answer 32

hypoglycemia

Question 33

lispro insulin (Humalog): contraindications

Answer 33

hypoglycemia, lower dose for people with renal disease

Question 34

glargine insulin (Lantus): class

Answer 34

Insulin- Long Acting

Question 35

glargine insulin (Lantus): Use

Answer 35

To control blood sugar in patients with type I diabetes or in patients with type II diabetes that could not get control with diet, exercise and oral agents

Question 36

glargine insulin (Lantus): EPA and onset

Answer 36

Onset is about 2 hours and there is no peak…acts like basal insulin

Question 37

glargine insulin (Lantus): ADR

Answer 37

hypoglycemia

Question 38

glargine insulin (Lantus): contraindications

Answer 38

hypoglycemia, lower does for renal disease

Question 39

Onset, Peak, and Duration of Rapid-acting "meal-time" insulin

Answer 39

onset=15 min, peak 30 min-2.5 hr, duration=3-6 hours lispro (Humalog) & aspart (Novolog)

Question 40

Onset, Peak, and Duration of Short acting insulin

Answer 40

onset=30-60 min, peak=1-5 hours, duration=6-10 hours Regular insulin (can be mixed with longer acting insulin)

Question 41

Onset, Peak, and Duration of Intermediate acting Insulin

Answer 41

onset=1-2 hours, peak=6-14 hours, duration=16-24 hours NPH insulin

Question 42

Onset, Peak, and Duration of Long-acting insulin

Answer 42

onset=2 hours, no peak, duration=18-24 hours glargine (Lantus)

Question 43

Nursing Considerations: Endocrine Insulin

Answer 43

administered in units, stores in refrigerator, can stay at room temp. for up to 1 month, do not expose to sunlight or high temperatures, mixed insulin do regular first (clear before cloudy), type I diabetes-insulin pumps use rapid-acting insulin

Question 44

Insulin Administration

Answer 44

injection subcutaneous, sites should be rotated (abdomen has greatest absorption, posterior upper arm, anterior thigh, hips are least absorptive)

Question 45

How to inject insulin

Answer 45

- Prime insulin pen with 2 units of insulin or draw up insulin in insulin syringe - Dial up correct amount of insulin on pen, or verify amount on syringe - Locate site of injection and clean skin with alcohol - With non-dominant hand hold and pinch area. - With dominant hand inject the insulin pen/needle at a 90-degree angle. - Hold in place for at least 5 seconds after administering insulin

Question 46

glucagon (GlucaGen): Class

Answer 46

Hyperglycemics

Question 47

glucagon (GlucaGen): other medications

Answer 47

50% glucose (D50-given IV)

Question 48

glucagon (GlucaGen): Use

Answer 48

Hypoglycemia from an insulin overdose

Question 49

glucagon (GlucaGen): EPA

Answer 49

Raises blood levels of glucose through glycogenesis.

Question 50

glucagon (GlucaGen): ADR

Answer 50

nausea, vomiting

Question 51

glucagon (GlucaGen): contraindications

Answer 51

hypersensitive

Question 52

glucagon (GlucaGen): RN Interventions

Answer 52

- Turn client on side if unconscious - Provide food after patient regains consciousness and able to swallow safely - Educate on signs and symptoms of hypoglycemia and how to treat