Seminar 3 Flashcards by Yaz Bassi

Fasting blood glucose
Normal:
Prediabetes:
Diabetes:

Normal: < or = 6 mmol/L
Prediabetes: 6.1 -6.9 mmol/L
Diabetes = or > 7.0 mmol/L

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Hemoglobin A1C
Normal:
At risk for diabetes:
Prediabetes:
Diabetes:

normal: less than 5.5%
at risk of diabetes: 5.5% – 5.9%
Prediabetes: 6.0 – 6.4
Diagnosis of type 2 diabetes: 6.5 % or greater

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Random Plasma Glucose

normal: 11.0mmol/L or less
Diabetes 11.1mmol/L or greater

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Nova machine Normal range

3.3 – 7.0 mmol/l

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Critically ill BG range

6-10

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non-critical BG range

5-8

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normal BG range

4-7

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Hypoglycemia or Hyperglycemia

Cool, clammy skin

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Rapid heart rate

Hypoglycemia

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Hypoglycemia or Hyperglycemia

faintness, dizziness

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Nervousness, tremors, shaking

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Hunger

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Emotional changes (eg. irritability)

hypoglycemia

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Hypoglycemia or Hyperglycemia

Numbness of fingers, toes, mouth

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Unsteady gait, slurred speech

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Changes in vision

Hypoglycemia

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Hypoglycemia or Hyperglycemia

Seizures, Coma

Hypoglycemia

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Hypoglycemia or hyperglycemia

Polyuria (increase in urination)
Polydipsia (increased thirst)
Polyphagia (increased hunger) followed by lack of appetite

hyperglycemia

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Hypoglycemia or hyperglycemia

Weakness, fatigue

hyperglycemia

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Hypoglycemia or hyperglycemia

Blurred vision

hyperglycemia

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Hypoglycemia or hyperglycemia

Headache

Both

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Hypoglycemia or hyperglycemia

Nausea and vomiting

hyperglycemia

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Hypoglycemia or hyperglycemia

Abdominal cramps

hyperglycemia

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Hypoglycemia or hyperglycemia

Glycosuria

Hyperglycemia

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What types of medications can cause hyperglycemia?

(eg. steroids, benzodiazepines) note: some clients may get insulin and not be diabetics but have high glucose due to steriod use.

blood glucose monitoring should be done when?

within 30 minutes before a meal (ac meal) or 2 hours after a meal (pc meal)

what colour end of test strip is inserted and what end is used to gather blood?

gold to machine, white to patient

How long are QC solutions good for?

90 days or 3 months. | 24 months from manufactor (unopened)

after how many hours does a QC lockout occur of the Nova glucometer?

24 hours without test preformed

How much blood is needed for the nova glucometer to read BG

1.2 uL (pinhead sized)

whole blood =

Capillary Venous Arterial

Where is the best place to poke your patient for blood glucose testing?

distal segment of 3rd or 4th finger – side of finger is best

# BGM steps BGM steps (6 steps)

1. prepare vascular site. 2. Prepare glucometer 3. Apply clean gloves 4. Pierce skin with lancet device 5. Wipe away first drop of blood 6. Apply second drop of blood to strip

# NOVA machine range *Adult Critical Low:

<2.6 mmol/l

# NOVA machine range *Adult Critical High:

>25 mmol/l

# BGM reading contaminating sample with interstitial fluid, will cause a false ?

false low results

# BGM reading Physiological influences that may affect results | 6 things

shock, dehydration, anemia, circulatory disorders, edema, extreme hematocrit outside acceptable range 0.10 – 0.60

If patient is hypoglycemic and able to swallow, what steps should be followed?

1) Give 20 grams of fast acting carb by mouth. -200 mL juice, 5 x 4 g glucose tablets, 4 packets of sugar, of 20 mL of honey 2) Check BG In 15 mins | If not successful after 45 mins, move to step B on hypoglycemic plan

If patient is hypoglycemic and is unconscious (without VAD access) what should the nurse do?

1) Give 1 mg of glucagon SC/IM first. 2) Notify physician STAT 3) Check glucose in 15 minutes

If patient is hypoglycemic and is unconscious and has a VAD available what should the nurse do?

1) Administer dextrose 50% injectable 10 grams IV over 2-3 mins 2) Notify physician 3) If not immediate response, administer dextrose 50 % injectable 15 grams over 2-3 mins 4) Check BG 15 mins

If a patient was treated for hypoglycemia following the hypoglycemia protocol, what should the follow up steps be for a client who is able to eat? What about if they cant eat?

CAN EAT: If meal is 1 hour away, give protein or carb snack CANNOT EAT: maintain IV with D10W at 50 ml/hr and notify doctor for more orders

NPH (Humulin N) is a).. acting

a) intermediate

Glargine (Lantus) is a).. acting

a) long

Degludec (Tresiba) is a).. acting

a) ultra long

Lispro (Humalog) is a)... acting

rapid acting

Regular (Humulin R) is a).. acting

short

Aspart (Novo-rapid) is a).. acting

a) rapid

# clear or cloudy some intermediate-acting insulins can be a)...

cloudy

Cloudy insulin is usually a).. acting insulin.

a) longer

Clear insulin is often a).. acting

a) shorter (but can also be longer acting)

is glargine clear or cloudy?

Clearrrr

# clear or cloudy - Aspart insulin and regular Insulin are always a).. ? - While NPH is b).. ?

a) Clear b) cloudy

What order do you draw clear and cloudy insulin in?

Always draw CLEAR first and then CLOUDY

When do insulin test strips expire?

3-6 months , should say on viall

basal insulin is required to

cover rise in blood glucose between meals and overnight

bolus insulin is required to

Required to cover rise in blood glucose due to meals

Pre mix insulin is used only in which type of diabetes

Type 2

the higher the ISF, the more sensitive the client is to insulin, which means?

patient requires less insulin

ISF calculation

100 divided by TDD

SC injections are absorbed more a) .. than IM

a) slowly

SC injections are administered into the a)..

a) loose connective tissue under the dermis

when is the SC route not reccomended?

severe, uncontrolled, escalating pain due to slow absorption.

generally an insulin pen needle is

4 mm – 12 mm (5/32 inch -1/2 inch)

the angle of insertion for SC injections is usually

90 degrees (though 45 degrees is also acceptable for a SC injection)

# gauge needle size ranges from

29 – 32 gauge (inner measurement or opening of needle)

What amount of medication can SC tissue hold

- only small doses (0.5 - 1 mL) of water-soluble medications should be given subcutaneously - (but up to 2 mL is safe)

Where can you give a SC insulin injection

the outer aspect of the upper arms, anterior and lateral portions of the thigh, buttocks and abdomen

subsequent injections should be given at least

2.5 cm away from the previous site

When giving insulin, what site has the quickest absorption

the abdomen

How to use an alcohol swab for injection:

must wipe for 15-30 seconds and let dry for 30-60 seconds to be effective

Seminar 3 Flashcards

(70 cards)