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NCLEX-RN (4) Pharmacology > Endocrine Meds > Flashcards

Flashcards in Endocrine Meds Deck (29)
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To treat high blood sugar for clients:

  • with diabetes mellitus
  • taking steroids 

Generic names:

Rapid-acting insulin

aspart, glulisine, lispro

Onset, Peak, Duration:

Rapid-acting insulin

Onset: 5 - 30 minutes (closer to 15 minutes)

Peak: 1 - 2 hours

Duration: 3 - 5 hours

Generic names:

Short-acting insulin


Regular insulin

Brand name: Humulin R

Onset, Peak, Duration:

Short-acting insulin: Regular subcutaneous


Onset: within 30 minutes

Peak: 2 - 4 hours

Duration: 8 hours

Onset, Peak, Duration:

Short-acting insulin: Regular IV infusion or IV push


Onset: 10 - 15 minutes

Peak: unknown

Duration: 4 hours


Why is it important to teach the client when insulin peaks?


The peak action time of insulin is when hypoglycemic reactions can occur. If the blood sugar gets too low, coma can occur.


Which insulin can be given IV infusion or IV push?


ONLY regular insulin is given IV


What types of insulins should a meal be readily available before administration?

Have meals readily available before giving rapid-acting and short-acting insulin.

This type of insulin works very quickly and can cause hypoglycemia if food is not consumed shortly after administration.


Regular IV insulin


To treat diabetic ketone acidosis (DKA)



What electrolyte should be checked while the client is receiving IV insulin?


Check potassium level when the client is on IV insulin.

Insulin lowers the potassium level.

Generic names:

Intermediate insulin

NPH and isophane

Brand name: Humulin N

Onset, Peak, Duration:

Intermediate insulin

Onset: 1 - 2 hours

Peak: 4 - 12 hours

Duration: up to 24 hours

Generic names:

Long-acting insulin

glargine, detemir

Can be given at bedtime.

Onset, Peak, Duration:

Long-acting insulin

Onset: 3 - 6 hours

Peak: constant

Duration: up to 24 hours


What types of insulins can be mixed and drawn up into the same syringe?

It's fine to mix intermediate insulin with rapid or short-acting.


What insulin is drawn up first and what insulin is drawn up second when drawing up the insulins that can be mixed?

  • draw up rapid-acting or short-acting first, which is clear
  • draw up intermediate-acting second, which is cloudy

"Clear before cloudy"


Sick day rules for insulin:

  1. check blood sugar every 4 hours still give insulin if indicated
  2. drinks fluids every hour - ​to prevent dehydration
  3. assess for signs of hyperglycemia - ketones in urine, fruity breath, deep and rapid respirations


Where are insulin bottles stored?

Insulin bottles are stored in the refrigerator until ready to be opened

after opening, bottles can be stored in refrigerator or at room temperature for 28 days


How is subcutaneous insulin administered?

Subcutaneous insulin guidelines:

  • clean skin with alcohol before injection
  • choose one area on the body to keep absorption rate the same
  • rotate around that site to prevent lipodystrophy
    • move at least 1.5" (3.8 cm) away from previous injection site


What is lipodystrophy?

lipodystrophy is fibrous fatty areas of the skin caused by repeated use of injections. 

Avoid these areas for subcutaneous shots.

Most common adverse reactions:

metformin (oral antidiabetic)

  • lactic acidosis
  • nausea/vomiting/diarrhea

This is due to toxicity and kidneys unable to get rid of acid build-up.


What are the signs and symptoms of lactic acidosis?

  1. dyspnea; deep and rapid respirations - to blow off extra CO2 gas
  2. dizziness, headache, lethargy, coma - acidosis affects the brain
  3. muscle weakness - due to increased potassium with acidosis


How long should metformin be held if the client is to receive IV contrast?

Hold metformin before and up to 48 hours afterwards for a client getting IV contrast for tests that end in -gram or -graphy.

Taking both together can cause kidney failure.

Nursing considerations:


  1. assess for chest pain and tachycardia
    • ​too much medicine can cause cardiac problems
  2. take in the morning on an empty stomach
    • better for absorption


What occurs if levothyroxine and warfarin are taken together?

The effects of warfarin are increased.

Check PT/INR.


Nursing considerations:

pancreatic enzymes


Take right before meals to help with food digestion in clients with cystic fibrosis or pancreatitis.


vasopressin, desmopressin

Anti-diuretic hormone (to treat shock and diabetes insipidus)


Nursing considerations:

vasopressin, desmopressin

Monitor blood pressure and heart rate

Can cause vasoconstriction