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NURS 2020 > Week 4 (Glucose) & Week 5 (Parenteral Equip) > Flashcards

Week 4 (Glucose) & Week 5 (Parenteral Equip) Flashcards

(55 cards)

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1
Q

What values of blood glucose are outside of the “acceptable range”?

A

< 2.2 mmol/L

> 20 mmol/L

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2
Q

What do you do if a patient’s blood glucose level is < 4 mmol/L?

A

Treat for hypoglycemia

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3
Q

What should you do if the PRE-operative blood glucose level is < 4 mmol/L or > 20 mmol/L?

A

Call the physician

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4
Q

What is the acceptable post-operative range for blood glucose?

A

Between 8 - 13 mmol/L

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5
Q

What should you do if the post-operative blood glucose level is > 13.5 mml/L?

A

Test urine for ketones

- if (+) monitor urine ketones q4h

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6
Q

Describe the characteristics of Type 1 diabetes

A

Auto-immune deficiency

  • beta cells stop producing insulin
  • typically early onset ( < 20 years old)
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7
Q

Describe the characteristics of Type 2 diabetes

A

Increased insulin resistance

- typically later onset ( > 40 years old)

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8
Q

What are the clinical S/S of hypoglycemia?

A
  1. Fatigue and malaise
  2. Trembling
  3. Irritability
  4. Headache
  5. Nausea
  6. Numbness
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9
Q

What are the clinical S/S of hyperglycemia

A
  1. Polyuria
  2. Polyphagia
  3. Polydipsia
  4. Fatigue
  5. Dry/itchy skin
  6. Poor wound healing
  7. Vision changes
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10
Q

What are some chronic complications of diabetes?

A
  1. Cardiovascular disease (HTN, heart disease, stroke)
  2. Kidney failure
  3. Blindness
  4. Nervous system damage
  5. Extremity amputations
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11
Q

How can hypoglycemia manifest?

A
  1. Hunger
  2. Tachycardia
  3. Sweating
  4. Nervous
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12
Q

What is a “normal” fasting blood glucose reading?

A

4 - 7 mmol/L

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13
Q

What is a “normal” blood glucose 2 hours after a meal?

A

5 - 10 mmol/L

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14
Q

What is the onset, peak, and duration of regular insulin?

A

Onset: 30 - 60 min
Peak: 2 - 4 hours
Duration: 6 - 8 hours Novolin R (or 8 - 12 hours Humulin R)

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15
Q

What is the onset, peak, and duration of long acting insulin?

A

Ultralente: 4 - 6 hours; 6 - 16 hours; and 4 - 36 hours
Glargine: 60 mins; none; 24 hours

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16
Q

What is the onset, peak, and duration of intermediate acting insulin (NPH)?

A

Onset: 60 min - 1.5 hours
Peak: 3 - 10 hours
Duration: 24 hours

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17
Q

What are the 4 ways to treat hypoglycemic episodes?

A
  1. 4 oz juice (or soda)
  2. 4 oz water with 4 sugar packets
  3. 8 oz low fat milk
  4. 50 % IV dextrose or glucagon if patient is not able to swallow
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18
Q

What is the only insulin that is cloudy?

A

Intermediate acting insulin ( NPH or Lente)

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19
Q

What is the site for intradermal injections?

A

Inner forearm

- assess in 48 - 72 hours if a skin test

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20
Q

What are the sites for insulin?

A

Rotate site within one region (intrasite rotation)

  • abdoment
  • back of arm
  • thigh
  • butt
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21
Q

What are the sites for subcutaneous injections?

A

Abdomen (not within 2” of umbilicus) or back of arm

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22
Q

What are the three sites for intramuscular injections?

A
  1. Ventrogluteal
  2. Vastus lateralis
  3. Deltoid
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23
Q

What is the angle of administration for intradermal injections?

Study These Flashcards
A

5 - 15 degrees

24
Q

What is the angle of administration for insulin?

Study These Flashcards
A

90 degrees = 2” pinch

45 degrees = 1” pinch

25
What is the angle of administration for subcutaneous injections?
90 degrees = 2" pinch | 45 degrees = 1" pinch
26
What is the angle of administration for intramuscular injections?
90 degrees
27
What is the needle length for intradermal, insulin, SC, and IM?
Intradermal: 3/8" Insulin: 3/8 - 5/8" SC: 3/8 - 5/8" IM: 1 - 1.5"
28
What is the needle gauge for intradermal, insulin, SC, and IM?
Intradermal: 25 - 30 Insulin: 25 - 30 SC: 25 - 28 IM: 19 - 25
29
What happens to the diameter of the needle as the gauge size gets bigger?
Diameter gets smaller and smaller | - it's opposite guys!
30
What is different about an insulin needle compared to other needles?
It's measured in units, instead of mL
31
What is the volume of fluid that is injected for intradermal, insulin, SC, and IM?
Intradermal: 0.01 - 0.1 mL Insulin: 1 - 100 UNITS SC: < 1 mL IM: < 3 mL (depending on the site)
32
Which injection do you have to aspirate on?
Intramuscular! | - as per hospital policy ...
33
Why is the ventrogluteal site preferable?
Preferred site for medications that are larger in volume, more viscous and irritating
34
Where is the bevel?
Opening of the needle (at the tip)
35
Where is the plunger?
The thing that you push ...
36
Where is the barrel?
Where the drug sits
37
Where is the needle?
If you don't know ...
38
Where is the shaft?
The long part of the needle (between bevel and hub)
39
Where is the hub?
The plastic connecting end of the needle
40
What parts of the needle and syringe must remain sterile when preparing a medication (6)?
1. Plunger 2. Luer tip of barrel 3. Inside of barrel 4. Needle hub 5. Shaft 6. Bevel
41
What do you put air into, an ampule or vial?
Vial
42
When mixing two drugs in a syringe what must you first know?
Compatability! | - CAN they be mixed?
43
When mixing two insulins in a syringe, which one is drawn up first?
1. Regular (Humulin R) - CLEAR | 2. Intermediate (NPH) - CLOUDY
44
What is the BEST action to take after giving an injection in order to dispose of your equipment?
Do not recap and discard the equipment in the sharps container in the patient's room (- put on safety lock if applicable)
45
What is the BEST action to take after preparing a medication?
Scoop cap
46
WHY do you not recap after giving an injection?
Recapping after giving an injection would NOT protect you from a needle stick injury and potential infection - may expose you to the most frequent route of exposure to blood borne disease for heath care providers
47
What is the most common but preventable method of contracting blood borne illness among health care workers?
Needle stick injuries
48
How can we as nurses prevent infection when administering injections?
- aseptic technique - prevent contamination of solution - prevent needle contamination - prepare skin - wash hands before preparing medication - wear gloves while administering
49
For needles, the higher the number, the _____ the size of the needle.
Smaller
50
You've just administered an injection, and your patient starting asking you questions. What do you do?
Go to the sharps container. ASAP! | - answer questions after
51
What do you do IF you have a needle stick injury?
GENTLY encourage bleeding - then wash with soap and water 1. Follow BCIT policy 2. Follow hospital policy
52
What type of syringe does Heparin go into?
TB syringe
53
Will a needle be contaminated if a drop of fluid runs down the needle and touches the syringe?
YES = because the needle is sterile but the syringe is not sterile
54
Why do you aspirate before giving an IM (as per hospital policy)?
To make sure that you're not in a blood vessel
55
What do you need to do if you draw up from an ampule?
Use a draw needle WITH a filter! | - prevents glass from getting into the solution

NURS 2020 (6 decks)

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