Insulin Actions and Uses Quiz

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Questions and Answers

Which type of insulin can be administered subcutaneously?

Only long-acting insulins

Only rapid-acting insulins

Only intermediate-acting insulins

All types of insulins (correct)

What is the proper sequence for mixing short and intermediate acting insulin?

Mix both insulins vigorously

Draw up intermediate acting insulin first

Put air in short acting insulin vial first

Draw up short acting insulin first (correct)

What is a common adverse effect associated with sulfonylureas?

Weight gain

Hyperglycemia

Hypertension

Hypoglycemia (correct)

Which action characterizes the mechanism of Biguanides?

Reduces hepatic glucose production Signup and view all the answers

What should be monitored closely when a client is on insulin therapy?

Signs of hypoglycemia Signup and view all the answers

Which type of diabetes can be treated effectively with oral hypoglycemics?

Type 2 diabetes Signup and view all the answers

Which symptom is NOT typical of hypoglycemia?

Excessive thirst Signup and view all the answers

What is a characteristic adverse effect of A-Glucosidase Inhibitors?

Flatulence Signup and view all the answers

What is the primary action of insulin in the body?

Helps glucose molecules enter muscle and adipose tissue cells Signup and view all the answers

Which of the following is a use of insulin?

Management of Type II diabetes Signup and view all the answers

What symptom is associated with hypoglycemia?

Cold, clammy skin and feeling faint Signup and view all the answers

Which statement is true regarding the treatment of severe hypoglycemia?

Quick-acting glucose like sugar or juice should be provided Signup and view all the answers

What are common adverse reactions to insulin?

Hypoglycemia and allergic reactions Signup and view all the answers

How does insulin affect fat storage in the body?

It helps store fats by preventing fat breakdown Signup and view all the answers

What is a key difference between hypoglycemia and hyperglycemia?

Hypoglycemia involves low blood sugar levels, while hyperglycemia involves high levels Signup and view all the answers

Which medication requires being held after radiological exams involving iodinated material?

Glucophage (metformin) Signup and view all the answers

Which of the following indicates hyperglycemia?

Dry, flushed skin with high sugar levels Signup and view all the answers

What is a common adverse reaction associated with meglitinides?

Back pain Signup and view all the answers

How long before meals should meglitinides be administered?

15-30 minutes Signup and view all the answers

Which of the following actions is NOT associated with thiazolidinediones?

Stimulate insulin release Signup and view all the answers

What is the proper timing for administering sulfonylureas?

30 minutes before meals Signup and view all the answers

Which of the following is an essential part of client teaching for diabetes management?

Avoid ETOH Signup and view all the answers

Which drug is categorized as a biguanide?

Metformin Signup and view all the answers

What should NOT be done once thiazolidinediones are taken?

Skip meals Signup and view all the answers

Study Notes

Insulin Actions

Insulin is produced by beta cells in the pancreas.
Primarily regulates glucose metabolism, but also influences amino acid and fatty acid storage and utilization.
Insulin lowers blood sugar by inhibiting glucose production in the liver and promoting glucose uptake by muscle and fat cells.
Stimulates protein synthesis
Facilitates fat storage by inhibiting its breakdown for energy.

Insulin Uses

Used to manage type 1 and type 2 diabetes (when diet is not sufficient control).
Useful in treating severe diabetic ketoacidosis.
Used with glucose to treat hyperkalemia.

Insulin Adverse Reactions

Hypoglycemia
- Characterized by coldness and clamminess, need for sweets
- Can be caused by:
  - Eating insufficiently
  - Incorrect dosage
  - Increased activity or illness.
Hyperglycemia
- Onset is gradual
- Blood glucose >250 mg/dL
- Drowsiness is a symptom
- Kussmaul respirations (deep and rapid)
- Nausea, loss of appetite
- Warm, dry skin
- Fruity-smelling breath, frequent urination

Insulin Nursing Interventions

Hypoglycemia
- Administer rapid-acting glucose, such as sugar or orange juice with sugar.
- Follow with a combination of carbohydrates and protein, such as a peanut butter sandwich with milk or cheese and crackers.
Hyperglycemia
Administer insulin as ordered, usually short-acting or a continuous insulin infusion.
Provide normal saline infusion at a rapid rate.

Insulin Administration

IV administration is only for short-acting insulin.
All insulins can be administered subcutaneously.
Use a dedicated insulin syringe.
Inject into the fatty layer of the back of the arm, abdomen, or upper leg.
Rapid-acting insulins should only be administered after the client's meal is available.
When mixing short and intermediate-acting insulin:
- Inject air into the intermediate-acting vial first.
- Then draw out the short-acting insulin.
- Long-acting insulins cannot be mixed with other types of insulin.
Insulin suspensions are mixed by rolling between palms (never shaking).
Always have another nurse verify the amount of insulin drawn up.
Rotate injection sites to prevent lipodystrophy (fat buildup).
Monitor for hypoglycemia, especially at the peak times for insulin.

Client Teaching Regarding Insulin

Proper blood glucose monitoring.
Importance of follow-up care.
How to draw up and self-administer insulin.
Dietary guidelines.
Management of insulin needs during illness.
How to manage insulin during travel.
Recognizing and managing hypoglycemia and hyperglycemia.
The importance of wearing a medical identification bracelet.

Oral Hypoglycemics

Oral hypoglycemics are used to treat type 2 diabetes when diet and exercise alone are insufficient.
They are not effective for the treatment of type 1 diabetes.

Sulfonylureas

Stimulate beta cells in the pancreas to release insulin.
Common adverse effects include nausea and hypoglycemia.
Common examples include Amaryl (glimepiride), Glucotrol (glipizide), Micronase, and DiaBeta (glyburide).

Alpha-Glucosidase Inhibitors

Delay the digestion and absorption of carbohydrates.
Common adverse effects include flatulence, diarrhea, and hypoglycemia.
Examples include Precose (acarbose) and Glyset (miglitol).

Biguanides

Reduce hepatic glucose production.
Increase insulin sensitivity in muscle and fat cells.
Common adverse effects include nausea, diarrhea, and lactic acidosis.
Examples include Glucophage (metformin).
Metformin should be held for 48 hours after radiological exams with iodinated contrast (like CT scans), unless otherwise specified by hospital policy.

Meglitinides

Stimulate the release of insulin from the pancreas.
Work more rapidly than sulfonylureas, but their duration is shorter.
Adverse effects include gastrointestinal symptoms and back pain.
Examples include Starlix (nateglinide) and Prandin (repaglinide).

Thiazolidinediones

Decrease insulin resistance.
Increase insulin sensitivity.
Used to treat type 2 diabetes, usually in combination with other oral hypoglycemics.
Adverse effects include headache, fatigue, hypoglycemia, and increased risk of infections.
Examples include Actos (pioglitazone) and Avandia (rosiglitazone).

Oral Hypoglycemic Nursing Interventions

Metglitinides: given 15-30 minutes before meals with each meal.
Biguanides: Given with meals.
Sulfonylureas: Glipizide 30 minutes before meals, glyburide with breakfast, and all others with food.
Alpha-glucosidase inhibitors: with the first bite of food, three times a day.
Thiazolidinediones: given with meals.

Client Teaching Regarding Oral Hypoglycemics

Importance of taking the medication as directed at the same time each day.
Following the prescribed diet plan closely.
Oral hypoglycemics do not replace the need for insulin.
Avoid alcohol consumption.
Regular blood glucose monitoring is crucial.
Good foot care and skin care are important.
Routine follow-up care and regular eye exams are necessary.
Moderate exercise is encouraged.
Inform healthcare providers about all medications, including over-the-counter medications, before taking any new medication.
If a meal is skipped, the corresponding dose of the medication should be skipped. If an additional meal is added, an additional dose of the medication should be taken.

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Description

This quiz explores the functions, uses, and potential adverse reactions of insulin, focusing on its role in diabetes management. It covers the mechanisms of insulin action, indications for use, and signs of hypo- and hyperglycemia. Test your understanding of this critical hormone in metabolic regulation.