Insulin and Anesthetic Considerations Flashcards Preview

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Flashcards in Insulin and Anesthetic Considerations Deck (16):
1

T/F to produce its cellular effects, insulin diffuses through the cell membrane to bind to its target receptors?

False, insulin binds to a cell membrane receptor and does not diffuse into the cell

2

T/F Regular insulin has the fastest onset and duration of action among the available formulations of insulin?

False, rapid acting insulin has the shortest onset and duration.

3

List the following insulins from shortest to longest duration
Glarigine
Regular
Lispro
NPH

Lispro
Regular
NPH
Glarigine

4

What triggers insulin release?

Elevated plasma glucose levels

5

What is the difference between type I and type II diabetes?

Type I is insulin deficient and Type II is insulin resistent

6

In the pre-operative setting , what must the anesthesia provider be aware of in a diabetic patient?

Cardiovascular function/Volume status
Renal Function/Electrolyte status
Patient's Glycemic control
Aspiration prophylaxis

7

T/F A significant risk of surgery is hypoglycemia due to the release of neuroendocrine hormones?

False, hyperglycemia is usually the concern

8

T/F Intraoperative hyperglycemia serves as a protective mechanism for post-op infections and promotes wound healing?

False, impairs wound healing and increases infection.

9

Where are the primary targets of insulin receptors?

The liver, muscle and adipose tissue (can be found on most cells of the body)

10

What are the effects of the neuroendocrine stress response?

Increased glucose production and decreased insulin secretion leaders to hyperglycemia and ketosis

11

What are goals in maintaining intraoperative glycemic management?

Maintain blood glucose in therapeutic range
Prevent metabolic disturbances related to hyper/hypoglycemia
Maintain fluid/electrolyte balance

12

How often should you measure blood glucose if the patient is on an insulin gtt?

Q1H

13

How should an elevated BG be treated while on an insulin gtt?

Sliding scale

14

On average how much does 1 unit of insulin decrease the BG?

Decreases BG by 40-50mg/dL

15

What is the half life and duration of Regular insulin and why is this important to know?

Regular insulin is used when the pt is on an insulin gtt,
1/2 Life: 7 min
duration:1 hr
Need to know if you are going to transition your patient from gtt to SQ injection in PACU

16

How do you adjust your insulin gtt rate?

Rate = last BG/150