Term
| If a pt has hypovolemia what type of fluid would you expect to give them and why? |
|
Definition
| Isotonic solution and you would give it to expand extracellular fluid volume |
|
|
Term
| NS can supply too much sodium and chloride in pts with what? |
|
Definition
| Compromised renal function, Heart failure, or edema |
|
|
Term
| What is the ONLY type of solution that is used when administering blood products? |
|
Definition
|
|
Term
| What is in Lactate Ringers solution? |
|
Definition
| Na, Cl, K, Ca, and Lactate |
|
|
Term
| What are the main things LR treats? |
|
Definition
| Hypovolemia, burns, and acute blood loss replacement |
|
|
Term
| Why should LR not be used in lactic acidosis? |
|
Definition
| Because the ability to convert lactate into HCO3 is impaired |
|
|
Term
| What type of condition would you not want to use LR in? |
|
Definition
| In a pt that has renal failure because it contains K and this can cause hyperkalemia |
|
|
Term
| What type of solution is D5W when it is in the bag? |
|
Definition
|
|
Term
| What would you treat with D5W? |
|
Definition
|
|
Term
| D5W is contraindicated in head injury,why? |
|
Definition
| Because it may cause increased ICP |
|
|
Term
| Why should D5W not be used for fluid resuscitation? |
|
Definition
| Because it can cause hyperglycemia |
|
|
Term
| What does D5W convert to in the body, why does it do this, and what can it lead too? |
|
Definition
| D5W converts to a hypotonic solution as dextrose is metabolized by the body and can lead to water intoxication |
|
|
Term
| What type of solution is 1/2 NS? |
|
Definition
|
|
Term
| When would you use 1/2 NS? |
|
Definition
| Used to treat sodium and chloride depletion and gastric fluid loss |
|
|
Term
| If you mix 1/2 NS with D5W what type of solution is it considered? |
|
Definition
|
|
Term
| What is an adverse reaction that happens when you use 1/2 NS? |
|
Definition
| Can cause fluid shift from vascular space into cells, causing cardiovascular collapse and increased ICP pressure |
|
|
Term
| 3%NS is what type of solution and what type of setting is appropriate for administration? |
|
Definition
| Is if Hypertonic and should only be delivered in a Critical care setting |
|
|
Term
|
Definition
| Used to increase ECF volume, decrease cellular swelling |
|
|
Term
| What type of electrolyte imbalance would you treat with 3%NS? |
|
Definition
|
|
Term
| Why do you give 3%NS slowly? |
|
Definition
| Because it can cause intavascular volume overload and pulmonary edema |
|
|
Term
| What type of fluid excess does 3%NS remove? |
|
Definition
|
|
Term
| Colloid solution is used as a what? |
|
Definition
|
|
Term
| Colloid solutions coat platelets and causes them to not do what? |
|
Definition
|
|
Term
| Colloid solutions are used to treat hypovolemia in early shock how? |
|
Definition
| By increasing pulse pressure, cardiac output, and arterial blood pressure |
|
|
Term
| When is a colloid solution contraindicated? |
|
Definition
| In hemorrhage, thrombocytopenia, renal disease, and severe dehydration |
|
|
Term
| Is a colloid solution a substitute for blood or blood products? |
|
Definition
|
|
Term
| What are foods high in Potassium? |
|
Definition
| Fruits like bananas and apricots |
|
|
Term
| What is the most characteristic manifestation of hypcalcemia and hypomagnesemia? |
|
Definition
|
|
Term
True or False:
The kidneys regulate acid-base balance by excreting or retaining hydrogen ions and reabsorbing or excreting bicarbonate ions in the blood? |
|
Definition
|
|
Term
| What is the most common buffer system in the body? |
|
Definition
| Bicarbonate-Carbonic acid buffer system |
|
|
Term
| What is normal oxygen saturation value for arterial blood? |
|
Definition
|
|
Term
| If a pt had sedative overdose which acid-base balance would be involved? |
|
Definition
|
|
Term
| If a pt had Hyperventilation which acid-base balance would be involved? |
|
Definition
|
|
Term
| If a pt had ketoacidosis which acid-base balance would be involved? |
|
Definition
|
|
Term
| If a pt had gastric suction which acid-base balance would be involved? |
|
Definition
|
|
Term
True or False:
The lungs regulate acid-base balance by controlling carbon dioxide levels by slowing or increasing ventilation? |
|
Definition
|
|
Term
| Which acid-base balance involves blood values with low pH and a low plasma bicarbonate concentration? |
|
Definition
|
|
Term
| What percentage of lipid emulsions can be safely infused through peripheral veins? |
|
Definition
|
|
Term
| An IV solution with an osmolality higher than that of serum is called |
|
Definition
|
|
Term
| What would be the most appropriate initial nursing intervention if you suspect cracked or broken tubing when administering parenteral nutrition to a patient? |
|
Definition
| Apply a padded hemostat between the break and the insertion site |
|
|
Term
| What is a disadvantage of using the median antecubital vein as an intravenous site? |
|
Definition
| Elbow joint needs to be in extension |
|
|
Term
| Which measure should you take to prevent hematoma at the venipuncture site? |
|
Definition
| Avoid making multiple entries into a vein |
|
|
Term
| A example of an isotonic intravenous solution is? |
|
Definition
|
|
Term
| What is the main indication for intermittent infusion using the piggyback method? |
|
Definition
| To administer drugs given over short periods at varying intervals |
|
|
Term
| If you detect signs of infection when you change your patients peripheral intravenous dressing, the main nursing intervention would be to? |
|
Definition
| Remove the intravenous catheter |
|
|
Term
| Your pt has diminished urine output, poor skin turgor, thirst, and dry, cracked lips. These most indicate what? |
|
Definition
|
|
Term
| The ONLY insulin that can be given intravenously is? |
|
Definition
|
|
Term
Which statement best desribes the key feature of Type I diabetes mellitus
A. Maturity onset, non-insulin dependent
B. Abrupt onset, juvenile onset, insulin dependent
C. Fatigue, rapid onset, diet controlled
D. Presents with end stage renal disease |
|
Definition
| B. Abrupt onset, Juvenile onset, Insulin dependent |
|
|
Term
| Rapid acting insulin like Lispro peaks in how many hours? |
|
Definition
|
|
Term
| Short acting insulins, like Regular, have a peak around how many hours? |
|
Definition
|
|
Term
True or False:
DKA is a condition that comes on gradually and causes high glucose levels with no ketone bodies? |
|
Definition
|
|
Term
| Hgb A1c is a blood test that reflects what? |
|
Definition
| Average blood glucose levels over 2-3 months |
|
|
Term
| The pathology behind Type 2 diabetes mellitus includes dysfunctional beta cells in the pancreas and insulin resistance. Because of this Type 2 diabetes mellitus is typically treated with what? |
|
Definition
| Oral hypoglycemics and diet control |
|
|
Term
| A microvascular problem that is caused by consistently high blood sugars in Diabetes patients is? |
|
Definition
| Nephropathy and diabetic retinopathy |
|
|
Term
| Metabolic Alkalosis is defined as |
|
Definition
|
|
Term
The circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities, include which of the following?
A. assisting the surgeon
B. Coordinating the surgical team
C. Setting up the sterile tables
D. all of the above functions |
|
Definition
| B. Coordinating the surgical team |
|
|
Term
What do the following values indicate?
pH= 7.28
PaCO2= 56
HCO3= 24 |
|
Definition
|
|
Term
| An expected patient outcome in the introperative phase is? |
|
Definition
| No unexpected safety problems |
|
|
Term
| Respiratory Alkalosis is always due to? |
|
Definition
|
|
Term
| A nurse know that perioperative risks increase with age because? |
|
Definition
•Ciliary actions decreases, reducing cough reflex
•Fatty tissue increases, prolonging the effects of anesthesia
•Liver size decreases, reducing the metabolism of anesthetics |
|
|
Term
| There are four stages to general anesthesia. An unconscious patient with normal pulse and respirations is considered to be in the stage known as what? |
|
Definition
|
|
Term
| How much of and adult body is water? |
|
Definition
|
|
Term
| What percent of water in body is extracellular? |
|
Definition
|
|
Term
| What percent of water in body is intracellular? |
|
Definition
|
|
Term
| If fluid is intavascular fluid where would it be? |
|
Definition
|
|
Term
| If fluid is interstitial fluid where would it be? |
|
Definition
| Between the blood vessels and cells |
|
|
Term
| If fluid is transcellular fluid where would it be? |
|
Definition
| Cerebrospinal, plural, peritoneal, and synovial fluid |
|
|
Term
| What would you expect the lab value of Hgb to be if there was an order to give blood? |
|
Definition
|
|
Term
| How fast do you administer blood usually? |
|
Definition
|
|
Term
| When do you administer Platelets? |
|
Definition
| You give platelets to correct thrombocytopenia platelet count under 20,000 |
|
|
Term
| How fast do you usually administer platelets? |
|
Definition
| 30 min; Special infusion set with smaller filter and shorter tubing |
|
|
Term
| When would you administer FFP? |
|
Definition
| To replace clotting factors and for fluid volume; PT or PTT 1.5 times normal |
|
|
Term
| How long do you usually take to administer FFP? |
|
Definition
|
|
Term
| When would you administer whole blood? |
|
Definition
| For volume replacement and increase oxygen. Usually in trauma or when body suffered >25% blood loss |
|
|
Term
| How long would you take to administer whole blood? |
|
Definition
|
|
Term
| Why would you administer Albumin? |
|
Definition
| Works as a volume expander; helps with fatty acid transport; helps regulate osmotic pressure of blood; can administer Albumin 5% (isotonic) or Albumin 25% (hypertonic) |
|
|
Term
| When would you use Cryoprecipitate (10-20 mls/unit) |
|
Definition
With hemophilia VIII or Von Willibrand's disease
Fibrinogen levels <100 mg/dl |
|
|
Term
| If a pt has a reaction to blood or blood products when does it usually happen? |
|
Definition
|
|
Term
| What conditions are you not supposed to use NS with? |
|
Definition
| heart failure, Pulmonary edema, renal impairment, sodium retention |
|
|
Term
| Once D5W is in the body what happens to it? |
|
Definition
| It converts to a hypotonic solution once the dextrose is metabolized |
|
|
Term
| When would you NOT want to use D5W? |
|
Definition
| With blood administration, Head injuries (because it can cause increased ICP R/T brain cells swelling), and can cause hyperglycemia |
|
|
Term
| When you you NOT want to use LR? |
|
Definition
•Do not use in lactic acidosis
•Do not use in renal failure
•Do not use if blood pH is greater than 7.5 |
|
|
Term
| What is a negative side effect of using hypotonic solution? |
|
Definition
| Can cause fluid shifts from vascular space into cells leading to cardiovascular collapse and increased ICP |
|
|
Term
| What percent dextrose must be administered through a central line? |
|
Definition
|
|
Term
| What is a negative side effect of hypertonic solution? |
|
Definition
Causes extracellular volume excess
---Precipitate circulatory overload, pulmonary edema and dehydration |
|
|
Term
| What are some complications of IV therapy? |
|
Definition
•Fluid overload
•Air embolism
•Septicemia and other infections
•Phlebitis
•Thrombophlebitis
•Hematoma
•Clotting and obstruction |
|
|
Term
| What gauge IV is needed for blood transfusion? |
|
Definition
|
|
Term
| What gauge is ok for most infusions? |
|
Definition
|
|
Term
| What gauge is best for children and older adults? |
|
Definition
|
|
Term
|
Definition
| When the IV fluid goes into the sub Q tissue and not the vein |
|
|
Term
|
Definition
| When the IV fluid goes into the muscle and not the vein |
|
|
Term
| How often should and IV catheter be changed? |
|
Definition
|
|
Term
| How often should a solution bag be changed? |
|
Definition
|
|
Term
| How often should IV tubing be replaced? |
|
Definition
|
|
Term
| How often should TPN tubing be changed? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| When drawing blood for phlebotomy what is the order of draw? |
|
Definition
| Red, Light blue, Red and Grey or Gold, Green and grey or light green, Green, Lavender, Gray |
|
|
Term
| If drawing blood for phlebotomy from the arm with an IV where must you draw from? |
|
Definition
| Below the IV site; if not possible infusion must be stopped for 15-20 min before draw can be done so that fluids do not contaminate sample |
|
|
Term
| If a Hypersensitivity reaction occurs to a medication that is being delivered via IV what should you do? |
|
Definition
•Stop the medication immediately
•Maintain or initiate patent IV access
•Observe the pt respiratory status
•Notify the physician
•Prepare to administer emergency medications
•Monitor VS
•Initiate resuscitation if respiratory or cardiopulmonary arrest occurs |
|
|
Term
| What is the main job of the circulating nurse during surgery? |
|
Definition
| Protects the patients safety and health |
|
|
Term
| What is an unrestricted zone? |
|
Definition
| This is where street clothes are ok |
|
|
Term
| What is a semirestricted zone? |
|
Definition
| This is where scrubs and caps are required |
|
|
Term
| What is a restricted zone? |
|
Definition
| Where scrubs, caps, shoe covers, and a mask are required |
|
|
Term
| What are some guidelines for surgical asepsis? |
|
Definition
•All material in contact with the wound and within the sterile field must be sterile
•Gowns are sterile in the front from chest to the level of the sterile field, and sleeves from 2 inches above the elbow to the cuff
•Only the top of a draped table is considered sterile. During draping, the drape is held well above the area and is placed from front to back
•Items are dispensed by methods to preserve sterility
•Movement of the surgical team are from sterile to sterile and from unsterile to unsterile only |
|
|
Term
| What are some health hazards associated with surgical environment? |
|
Definition
•Laser risk
•Exposure to blood and body fluids
•Latex allergy
•Radiation
•Toxic agents |
|
|
Term
| What are some gerontologic considerations for surgery |
|
Definition
•Increased likelihood of coexisting conditions
•Aging heart and pulmonary systems
•Decrease homeostatic mechanisms
•Changes in responses to drugs and anesthetic agents due to aging changes such as decreased renal function, and changes in body composition of fat and water |
|
|
Term
| What are some nursing goals for the patient in the intraoperative period? |
|
Definition
•Reducing anxiety
•Preventing positioning injuries
•Maintaining patient safety
•Maintaining the patient's dignity
•Avoiding complications
•The nurse is always in the role of the patient advocate |
|
|
Term
| What is considered Minimal Sedation? |
|
Definition
| Relaxed, easily arousable, can answer questions and follow directions |
|
|
Term
| What is considered Moderate Sedation (Needs close monitoring)? |
|
Definition
| Conscious sedation, feel drowsy, may sleep, easily awakened, may not remember procedure and process |
|
|
Term
| What is considered Deep sedation (Need very close monitoring)? |
|
Definition
| Sleeping through procedure, supplemental oxygen and airway support. |
|
|
Term
| What are the different stages of Anesthesia? |
|
Definition
•Stage 1 Induction
•Stage 2 Excitement
•Stage 3 Surgical Anesthesia
•Stage 4 Medullary Depression |
|
|
Term
| What happens in anesthesia stage 1 Induction? |
|
Definition
| Beginning of administration of anesthetic to loss of consciousness (25 seconds to 1 min). Unnecessary noises and motions are avoided |
|
|
Term
| What happens in anesthesia stage 2 excitement? |
|
Definition
| From loss of consciousness to relaxation. Uncontrolled patient movements ma occur/ ready to restrain patient |
|
|
Term
| What happens in anesthesia stage 3 Surgical anesthesia? |
|
Definition
| Relaxation to loss of reflexes |
|
|
Term
| What happens in anesthesia stage 4 Medullary depression? |
|
Definition
| Loss of reflexes to death. Too much anesthesia and needs reversal |
|
|
Term
| How is General Anesthesia delivered? |
|
Definition
|
|
Term
| How is regional anesthesia delivered? |
|
Definition
•Epidural anesthesia
•Spinal anesthesia
•Local conduction blocks |
|
|
Term
| What are some nursing interventions for surgical positioning? |
|
Definition
•Place in comfortable position as possible
•Pad bony prominences
•Protect nerves
•Skin is not pinched
•Do not hyperextend joints |
|
|
Term
| What are physiologic responses to surgery? |
|
Definition
•Incision of the skin
•Blood and fluid loss
•Removal of tissues or organs
•Initiation of the stress response
•Pupil dilation |
|
|
Term
| What are some key things about malignant hyperthermia? |
|
Definition
•Inherited disorder
•Potential fatal
•Chemically induced by anesthetic agents
•Hypermetabolic condition in skeletal muscles
•Involves altered calcium function at the cellular level |
|
|
Term
| What are the S/S of malignant hyperthermia? |
|
Definition
- Tachycardia
- Rigidity
- Tetanus like movements, often in the jaw
- Hyeprthermia (late sign)
- Ventricular dysrhythmia
- Hypotension
- Decreased cardiac output
- Oliguria
- Cardiac arrest
|
|
|
Term
| What are some goals for managment of malignant hyperthermia? |
|
Definition
- Recognize S/S early
- Discontinue anesthesia
- Decrease metabolism
- Reverse metabolic and respiratory acidosis
- orrect dysrhythmias
- Decrease body temp
- Provide oxygen 100%
- Correct electrolyte imbalance
|
|
|
Term
| What meds do you want to administer when malignant hyperthermia is suspected? |
|
Definition
Dantrolene Sodium
and
Sodium Bicarbonate |
|
|
Term
True or False:
The circulating nurse is responsible for
- Coordinating and documenting patient care in the operating room
- Safe functioning of equipment
- Availability of supplies and materials
|
|
Definition
|
|
Term
| Through which route are general anesthetics primaritly eliminated? |
|
Definition
|
|
Term
| Who transfers the pt from OR to PACU? |
|
Definition
| Circulating nurse and Anesthesiologist |
|
|
Term
| What tool is used to assess pt's in PACU? |
|
Definition
|
|
Term
True or False:
The primary nursing goal in the immediate postop period is maintenance of pulmonary function and prevention of laryngospasm? |
|
Definition
| False because the laryngospasm should not be an issue, that is checked before going to PACU from OR |
|
|
Term
True or False:
The most important nursing intervention when vomiting occur postoperatively is to turn the pt;s head to prevent aspiration of vomitus into the lungs? |
|
Definition
| False, unless contraindicated due to surgical procedure you want to turn the whole body to the side and be sure to have suction ready as well to help expel any fluids from the mouth and throat |
|
|
Term
| Who does the first dressing change? |
|
Definition
| A member of the surgical team, usually the Dr or one of his staff, they may take it off and have the RN redress it |
|
|
Term
| What is Dehiscence of a wound? |
|
Definition
| When a incision opens postoperative |
|
|
Term
| What is evisceration of a wound |
|
Definition
| When a wound dehisces and tissue or organs are protruding through the wound |
|
|
Term
| What is normal plasma pH? |
|
Definition
|
|
Term
| What is regulated by the kidney's in the ECF? |
|
Definition
| Kidneys regulate bicarbonate in ECF |
|
|
Term
| What do the lungs regulate in the ECF? |
|
Definition
| Lungs under the control of the medulla regulate CO2 and, therefore, carbonic acid in ECF |
|
|
Term
| What are some causes of metabolic acidosis? |
|
Definition
| Diarrhea, DKA, Salicylate OD, Renal Failure, Sepsis, Shock |
|
|
Term
| What are S/S of Metabolic Acidosis? |
|
Definition
| Headache, confusion, drowsiness, increased respiratory rate and depth, decreased BP, decreased Cardiac Output, dysrhythmias, shock;if decrease is slow pt may be asymptomatic until bicarb is 15 mEq/L or less |
|
|
Term
| What lab values go with Metabolic Acidosis? |
|
Definition
Low pH < 7.35
Low bicarb < 22 mEq/L |
|
|
Term
| What electrolyte balance goes with Metabolic Acidosis? |
|
Definition
| Hyperkalemia may occur as potassium shifts out of the cell |
|
|
Term
| What electrolyte imbalance goes with CHRONIC metabolic acidosis? |
|
Definition
| Hypocalcemia; Serum calcium levels may be low with chronic metabolic acidosis and must be corrected before treating the acidosis |
|
|
Term
| What lab values would you expect with Metabolic Alkalosis? |
|
Definition
High pH > 7.45
High bicarb > 26 mEq/L |
|
|
Term
| What are some common causes of metabolic alkalosis? |
|
Definition
| Loss of stomach acid, use of steroids or diuretic drugs, overuse of antacids, or laxatives |
|
|
Term
| What electrolyte imbalance would you expect to see with metabolic alkalosis? |
|
Definition
|
|
Term
| What lab values would you expect to see with respiratory acidosis? |
|
Definition
Low pH < 7.35
High PaCO2 > 45 mm Hg |
|
|
Term
| What is the cause of respiratory acidosis? |
|
Definition
Always due to a respiratory problemwith inadequate excretion of CO2
Hypoventilation R/T some inderlying cause (example: drug OD, pulmonary edema, chest trauma, neruomuscular diseases, airway obstruction, COPD) |
|
|
Term
| What are lab results that you would expect to see with respiratory alkalosis? |
|
Definition
High pH > 7.45
Low PaCO2 < 35 mm Hg |
|
|
Term
| What is common cause of respiratory alkalosis? |
|
Definition
Always due to hyperventilation
Hyperventilation R/T initial stages of PE, Hypoxia, Fever, Pregnancy, Anxiety, High Altitudes |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
If pH ↓ and HCO3 ↓
What is this? |
|
Definition
|
|
Term
What if pH ↑ and HCO3 ↑
What is this? |
|
Definition
|
|
Term
What if pH ↓ and CO2 ↑
What is this? |
|
Definition
Respiratory Acidosis
(Hypoventilation) |
|
|
Term
What if pH ↑ and CO2 ↓
What is this? |
|
Definition
Respiratory Alkalosis
(Hyperventilation) |
|
|
Term
| What does ROME stand for? |
|
Definition
Respiratory
Opposite
Metabolic
Equal |
|
|
Term
| What is the difference between Type 1 and Type 2 Diabetes? |
|
Definition
Type 1 is when insulin producing beta cells in the pancreas are destroyed by an autoimmune process; Requires insulin becuase little or no insulin is produced; most common complication is DKA
Type 2 is when there is decreased sensitivity to insulin (insulin resistance) and impaired beta cell funtion results in decreased insulin production; treated initially with diet and exercise; most common complication is HHNS |
|
|
Term
| What are some risk factors for Type 2 diabetes? |
|
Definition
- Family history of diabetes
- Obesity
- Race/ethnicity
- Age greater then 45 years
- Previous identified impaired fasting glucose or impaired glucose tolerance
- Hypertension > 140/90
- HDL < 35 or triglycerides > 250
- history of gestational diabetes or babies over 9 lbs
|
|
|
Term
| What are the three "P's" to look for? |
|
Definition
| Polyuria, Polydypsi, Polyphagia |
|
|
Term
| What are some clinical manifestations for diabetes (undiagnosed)? |
|
Definition
- Fatigue, weakness, vision changes, tingling or numbness in hands or fet, dry skin, skin lesions or wounds that are slow to heal, recurrent infections
- Type 1 may have sudden weight loss, N/V, and abd pain if DKA has developed
|
|
|
Term
| What would you expect to see when checking blood sugar on a person suspected (but not diagnosed) of diabetes? |
|
Definition
Fasting 126 or more
Random 200 or more |
|
|
Term
| What is the renal threshold for glucose? |
|
Definition
|
|
Term
| What type of foods should you combine starchy foods with if a pt is diabetic? |
|
Definition
| Combine starchy food with protein and fat ontaining food slows absorption, and glycemic response |
|
|
Term
| Which insulins are rapid acting? |
|
Definition
Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra) |
|
|
Term
| Which insulins are Short acting? |
|
Definition
| Regular (Humalog R, Novolin R, Iletin II regular) |
|
|
Term
| Which insulins are Intermediate acting? |
|
Definition
NPH
Humulin N
Novolin L
Novolin N |
|
|
Term
| Which insulins are long acting? |
|
Definition
Glargine (Lantus)
Detemir (Levemir) |
|
|
Term
What is the O, P, and D for rapid acting insulin?
|
|
Definition
O- 5-15 min
P- 30-60 min
D- 2-4 hrs |
|
|
Term
| What is the O, P, and D for Short acting insulin? |
|
Definition
O- 30-60 min
P- 2-3 hrs
D- 4-6 hrs |
|
|
Term
| What is the O, P, and D of intermediate acting insulin? |
|
Definition
O- 2-4 hrs
P- 4-12 hrs
D- 16-20 hrs |
|
|
Term
| What is the O, P, and D of long acting insulin? |
|
Definition
O- 1 hr
P- no peak
D- 24 hrs |
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Term
| Which is the only insulin that can be given intravenously? |
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Definition
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Term
| Which insulin cannot be mixed with any other insulin? |
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Definition
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Term
| Why is Hgb A1c level important to the diabetic pt? |
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Definition
| It shows wether or not the blood glucose has been stable over the last 2-3 months. The goal for a diabetic pt is under 7% |
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Term
| How do you treat the Dawn phenomenon? |
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Definition
| Change time of injection of evening intermediate acting insulin fom dinnertime to bedtime |
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Term
| How do you treat the Somogyi Effect? |
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Definition
| Decrease evening (prediner or bedtime) dose of intermediate acting insulin, or increase bedtime snack |
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Term
| What are S/S of hypoglycemia? |
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Definition
- Blood glucose less than 50 or 60
- Shakiness
- Sweating
- Nervousness
- Hunger
- Weakness
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Term
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Definition
- Hyperglycemia
- Dehydration and elctrolyte loss
- Acidosis
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Term
| Will there be serum and urine ketones present with DKA or HHNS? |
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Definition
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Term
| What should a diabetic do on a "sick day?" |
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Definition
- Take insulin or oral antidabetic agents as usual
- Test blood glucose and test urine ketones every 3 to 4 hours
- May need to supplement doses of regular insulin every 3 to 4 hours if taken normally
- If vomiting diarrhea, or fever persists, take liquids every 1/2 hours to 1 hour to prevent dehydration and to provide calories
- Report N/V/D to health care provider
- If not able to keep down fluids may need hospitalization to prevent DKA or coma
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Term
Which category of insulin is rapid acting?
- Humalog
- Humalog R
- Humulin N
- Glargine (Lantus)
What is the O, P, and D of this insulin? |
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Definition
1. Humalog
O- 5-15 min
P- 30-60 min
D- 2-4 hrs |
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Term
| Which type of diabetes would a dr prescribe oral antidiabetic agents? |
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Definition
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Term
| What is a major side effect of oral antidiabetic agents? |
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Definition
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Term
| What are some acute complications of DM? |
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Definition
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Term
| What are the MACROvascular complications of DM? |
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Definition
- Accelerated atherosclerotic changes
- Coronary artery disease, cerebrovascular disease, and peripheral vascular disease
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Term
| What are the MICROvascular complications of DM? |
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Definition
Diabetic retinopathy
Nephropathy |
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Term
| What are the neuropathic changes in DM? |
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Definition
| Peripheral neuropatyh, autonomic neuropathies, hypoglycemic unawareness, sexual dysfunction |
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Term
| What would you give a diabetic who was experiencing hypoglycemia? |
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Definition
- 15g of fast acting, concentrated carbohydrate
- 3 or 4 glucose tablets
- 4-6 oz of juice or REGULAR soda (not diet)
- 6-10 hard candies
- 2-3 teaspoons of honey
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Term
| If a diabetic pt was unconscious and was experiencing hypoglycemia what would you do? |
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Definition
| Give SubQ or IM glucagon 1 mg or 25-50 mL 50% dextrose solution IV (D50) |
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Term
| If a pt experienced hypoglycemia and it was treated would you hold the next ordered dose of insulin? |
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Definition
| No not unless it was ordered held by the physician |
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Term
| If a pt was in DKA what would you do to treat? |
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Definition
- Rehydration with IV fluids
- IV continuous infusion of regular insulin
- Reverse acidosis and restore electrolyte balance
- Monitor WBG, EKG, F&E levels, K especially, VS Lung assessments, Signs of fluid overload
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Term
| What would you do to treat a pt with HHNS? |
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Definition
| Rehydration, Insulin adminstration, Monitor F&E balance |
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Term
| What are some manifestations of HHNS? |
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Definition
| Hypotension, profound dehydration, tachycardia, and variable neurologic signs due to cerebral dehydration |
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