Types of Insulin

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Questions and Answers

A patient with type 1 diabetes is prescribed insulin. Which type of insulin would mimic the normal endogenous insulin release in response to a meal?

  • Insulin lispro (correct)
  • NPH insulin
  • Regular insulin
  • Insulin glargine

A patient is prescribed NPH insulin at 7:00 AM. The nurse anticipates the highest risk of hypoglycemia for this patient will occur during what time frame?

  • 11:00 AM - 3:00 PM (correct)
  • 4:00 PM - 10:00 PM
  • 8:00 AM - 10:00 AM
  • 2:00 AM - 6:00 AM

A patient with type 2 diabetes is prescribed insulin detemir. What is the primary characteristic of this insulin that the nurse should emphasize in patient education?

  • It provides a long-lasting background level of insulin and should be taken at the same time each day. (correct)
  • It has a rapid onset, so administer it 15 minutes before meals.
  • It should be administered intravenously only in emergency situations.
  • It can be mixed with short-acting insulin in the same syringe.

A patient newly diagnosed with type 1 diabetes asks why they need insulin injections instead of oral medication. What is the most accurate explanation?

<p>Patients with type 1 diabetes have autoimmune destruction of pancreatic beta cells, requiring exogenous insulin for survival. (C)</p> Signup and view all the answers

A pregnant patient is diagnosed with gestational diabetes. What is the physiological basis for this condition?

<p>Hormonal insulin resistance during pregnancy (A)</p> Signup and view all the answers

A patient with diabetes is admitted to the hospital with hyperglycemia. The provider orders IV insulin. Which type of insulin is appropriate to administer intravenously?

<p>Regular insulin (D)</p> Signup and view all the answers

A nurse is teaching a patient about recognizing hypoglycemia. Which of the following instructions is most important for the nurse to include?

<p>Carry a fast-acting source of glucose and check blood sugar if symptoms occur. (D)</p> Signup and view all the answers

A patient taking insulin reports consistently high blood glucose levels in the morning, despite increasing the evening dose of long-acting insulin. What phenomenon should the nurse suspect?

<p>Dawn phenomenon (D)</p> Signup and view all the answers

A patient is prescribed both regular insulin and NPH insulin to manage type 2 diabetes. What instructions should the nurse provide regarding the mixing of these insulins?

<p>Draw up the regular insulin first, then the NPH insulin, to avoid contaminating the regular insulin. (C)</p> Signup and view all the answers

A patient with diabetes develops a foot ulcer. What is the most important aspect of patient education regarding foot care?

<p>Inspect feet daily and report any abnormalities. (B)</p> Signup and view all the answers

What is the treatment for a patient experiencing hypoglycemia?

<p>Provide 15g of rapid-acting carbohydrates and recheck blood sugar in 15 minutes. (A)</p> Signup and view all the answers

A patient with type 1 diabetes is planning to start an exercise program. What adjustment to their meal plan and insulin regimen should be made to prevent hypoglycemia?

<p>Eat extra carbohydrates before, during, or after exercise. (B)</p> Signup and view all the answers

A patient is found unresponsive with a blood glucose of 40 mg/dL. What should the nurse do first?

<p>Administer intravenous dextrose or intramuscular glucagon. (A)</p> Signup and view all the answers

A nurse is teaching a group of patients about sick day rules for diabetes management. Which guideline is most important to emphasize?

<p>Monitor blood glucose more frequently and continue taking insulin. (C)</p> Signup and view all the answers

What potential long-term complication of diabetes should the nurse prioritize during patient education?

<p>Eye, kidney, nerve, and cardiovascular diseases. (A)</p> Signup and view all the answers

A patient with diabetes is prescribed a statin medication. What is the primary reason for this medication prescription??

<p>To reduce risk of cardiovascular events (A)</p> Signup and view all the answers

A patient with type 2 diabetes is prescribed an oral medication that increases insulin sensitivity and reduces glucose production in the liver. Which medication class is most likely prescribed?

<p>Biguanides (A)</p> Signup and view all the answers

A patient with diabetes is experiencing symptoms of gastroparesis. What dietary modification is most appropriate to recommend?

<p>Small, frequent meals (B)</p> Signup and view all the answers

A nurse is providing education to a patient with diabetes on how to administer insulin. The nurse should use which part of the body for the most consistent absorption?

<p>Abdomen (A)</p> Signup and view all the answers

The provider suspects a patient has Somogyi effect. To confirm the provider's suspicions, when should the nurse instruct the patient to check their blood glucose?

<p>Around 3:00 AM (A)</p> Signup and view all the answers

Flashcards

Rapid-Acting Insulin

Insulin that starts working very quickly, typically within 10-15 minutes, and lasts for 3-5 hours.

Short-Acting Insulin

Insulin that takes about 30-60 minutes to start working and lasts for 5-8 hours.

Intermediate-Acting Insulin

Insulin with an onset of 1-2 hours, peaks in 4-12 hours, and lasts for 12-18 hours. Appears cloudy and needs mixing.

Long-Acting Insulin

Insulin that has a slow onset (1-2 hours), minimal peak, and lasts around 24 hours, providing a basal level of insulin.

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Type 1 Diabetes (T1DM)

An autoimmune condition where the body destroys insulin-producing beta cells in the pancreas, leading to insulin deficiency.

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Type 2 Diabetes (T2DM)

A condition characterized by insulin resistance and beta-cell dysfunction, often associated with lifestyle factors.

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Gestational Diabetes (GDM)

Diabetes that develops during pregnancy due to hormonal insulin resistance.

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Diabetes Assessment

Monitor blood glucose levels, assess for symptoms of hypo/hyperglycemia, and review patient adherence to treatment plans.

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Diabetes Medications Education

Teach patients how to properly administer medications and recognize and manage potential side effects.

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Diabetes Nutrition

Advise patients on carb counting, balanced diet for BG control.

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Diabetes and Exercise

Encourage regular physical activity and emphasize the importance of monitoring blood glucose levels during exercise.

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DKA/HHS Management

Monitor patient hydration status and administer insulin/fluids as needed to address DKA/HHS.

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Diabetes Education

Review monitoring techniques, sick day rules, and foot care practices to prevent complications.

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Patient Teaching (Diabetes)

Inspect feet daily, understand sick day insulin adjustments, and recognize warning signs.

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Diabetes Complications

Diabetes complications include eye, kidney, nerve, and cardiovascular diseases.

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Hypoglycemia Treatment

Treat with 15g of carbs, recheck in 15 minutes

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Study Notes

Types of Insulin

  • Rapid-acting insulin examples include insulin lispro (Humalog), insulin aspart (NovoLog), and insulin glulisine (Apidra).
  • The onset for rapid-acting insulin is 10-15 minutes, peaks in 1-2 hours, and lasts for 3-5 hours.
  • Rapid-acting insulin should be taken before meals, and patients should be monitored for hypoglycemia.
  • Short-acting insulin includes regular insulin (Humulin R, Novolin R).
  • Short acting insulin will onset in 30-60 minutes, peaks in 2-4 hours, and lasts for 5-8 hours.
  • Short-acting insulin can be administered intravenously or subcutaneously 30 minutes before meals.
  • Intermediate-acting insulin includes NPH insulin (Humulin N, Novolin N).
  • Intermediate acting insulin has a onset of 1-2 hours, a peak of 4-12 hours, and a duration of 12-18 hours.
  • NPH insulin appears cloudy and should be rolled to mix; it is often taken twice daily (BID).
  • Long-acting insulin includes insulin glargine (Lantus) and insulin detemir (Levemir).
  • Long-acting insulin has a 1-2 hour onset, minimal peak, and lasts about 24 hours.
  • Long-acting insulins should not be mixed and should be taken at the same time daily.

Types of Diabetes

  • Type 1 Diabetes (T1DM) is caused by autoimmune beta-cell destruction.
  • Treatment for T1DM includes lifelong insulin, carbohydrate counting, and blood glucose monitoring.
  • Type 2 Diabetes (T2DM) is caused by insulin resistance and beta-cell dysfunction.
  • Risk factors for T2DM include obesity, sedentary lifestyle, and family history.
  • Management of T2DM includes lifestyle adjustments, oral medications, and insulin as needed.
  • Gestational Diabetes (GDM) is caused by hormonal insulin resistance during pregnancy.
  • Management of GDM includes diet, exercise, and insulin if needed.
  • Other specific types of diabetes include MODY (Maturity-Onset Diabetes of the Young), LADA (Latent Autoimmune Diabetes in Adults), and diabetes caused by secondary factors like steroids or pancreatitis.

Nursing Care for Diabetes

  • Assessment involves monitoring blood glucose, assessing symptoms, and reviewing adherence to treatment plans.
  • Nursing interventions include teaching proper medication use and side effects, promoting carbohydrate counting and a balanced diet, encouraging physical activity, and blood glucose monitoring.
  • Hypoglycemia should be treated with 15g of carbohydrates, and blood glucose should be rechecked in 15 minutes.
  • Diabetic Ketoacidosis/Hyperosmolar Hyperglycemic Syndrome (DKA/HHS) require monitoring hydration and administering insulin and fluids.
  • Education includes teaching about self-monitoring, sick day rules, and foot care.
  • Patient teaching: Inspect feet daily, understand sick day insulin use, and recognize warning signs.
  • Diabetes complications can affect the eyes, kidneys, nerves, and cardiovascular system.

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