Flashcards in Endocrine: 2 Deck (17):
glycosylated hemoglobin (hbA1c): blood test; gives an average of what your blood sugar has been over the past ____
illness= think (diabetes)
should you aspirate insulin?
NO , to reduce the trauma of the skin
insulin infusion pump:
-only ____insulin is used in infusion pump.
alternate to insulin injections
____ is the only insulin that can be given in IV fluid as an intravenous infusion.
____ is the only insulin that can be given via SQ insulin infusion pump. insulin infusion pump are small computerized device worn by the client that provide both a ____ dosing of rapid-acting insulin and on-demand (bolud) dosing.
rapid acting insulin
s/s of hypoglycemia
if hypogylcemic, what should client do?
glucose absorbtion is delayed in food with lots of __.
once the blood sugar is up, what should they do?
eat simple sugar
eat complex carb and protein
what is important about d5w?
hard to push, if you have a choice you need a large bore IV
for prevention of hypoglycemia, teach the client to
take insulin regular
know sign of hypoglycemia
check blood sugar regularly
hypoglycemia is a glucose level of ____
70 or less
anything that increases blood sugar can throw a client into DKA (illness, infection, skipping insulin)
-DKA may be the first sign of type 1
-have all the usual s/s of type 1
-patho: absent or inadequate insulin--blood sugar goes sky high--polyuria,polydipsia,polyphagia-- fat breakdown(acidosis)--kussmaul's respiration (trying to blow off co2 to compensate for the met. acidosis), also, as the client becomes more acidotic, the LOC does DOWN!
treatment for DKA
-find the cause
-hourly blood sugar and potassium level
-IV insulin (insulin decreases glucose and potassium by driving them out of the vascular space into the cell)
-IVFs--start with NS.. then when the blood sugar gets down to about 300, switch to d5w to prevent throwing the client into hypoglycemia
-anticipate that the physician will want to add potassium to the iv solution at some point
HHNK or HHS is...
Hyperosmolar hyperglycemic nonketosis or hyperglycemic hyperosmolar state
-looks like dka, but no acidosis
-making just enough insulin so they are not breaking down fat. no fat breakdown...no acidosis, no ketones...no acidosis
-no fruity breath odor
-no kussmauls respirations
DKA happens in ___ whereas HHNK (HHS) happens in ___.
DKA and HHNK are both hyperosmolar state caused by ____ and ____, but there is no ____ with HHNK.
what is gastroparesis?
stomach empyting is delayed so there is an increased risk for aspiration