Insulin regimens used for type 1 diabetes type

This preview shows page 43 - 46 out of 49 pages.

Insulin regimens - Used for type 1 diabetes - type 2/gestational diabetes if glycemic control not controlled by diet, exercise, oral hypoglycemic agents Insulin pump Continuous infusion of insulin, needle change every 2 to 3 days to prevent infection Complication of insulin pump - Accidental cessation of insulin administration - obstruction of tubing/needle - pump failure - infection 43
44 Pharmacology ATI Insulin pens Prefilled cartridges 150 to 300 units in programmable device with disposable needles, used only for one type insulin at a time, convenient for travel Oral hypoglycemics Used for Type 2 diabetes along with diet and exercise to regulate blood glucose Rapid acting insulin Lispro(Humalog), aspart (NovoLog), glulisine (Apidra) Administer before Meals, onset 10 to 30 minutes, admin in conjunction with intermediate/long acting insulin to provide glycemic control between meals/at night Short acting insulin Regular (Humulin R, Novolin R), admin 30 to 60 minutes before Meals, available in two concentrations - U-500 for patients who have insulin resistance/never administer IV -U-100 used by most clients,may be administered IV Intermediate acting insulin NPH (Humulin N), detemir (levemir) -Admin between Meals/at night - do not admin before meals - contains protamine (protein)which caused the delay in insulin absorption/onset/extends duration of action of the insulin - administer NPH subq only (only insulin to mix with short acting insulin) - Administered detemir subQ only(never mixed with other insulin) Long-acting insulin Glargine (Lantus) - Admin once daily, anytime during the day always at the same time - forms microprecipitates that dissolves slowly over 24 hours/maintain steady blood sugar - subq only /never IV Client education - insulin Rotate injection sites (prevent Lipohypertrophy) within one anatomic site - inject at 90° angle 45° if skin then do not aspirate for blood - when mixing insulins draw up short acting insulin into syringe first then long-acting Manifestations of hypoglycemia Mild shakiness, mental confusion, sweating, palpitations, headache, lack of coordination, blurred vision, seizures and coma Hypoglycemia preventive measures Avoid excess insulin, exercise, alcohol consumption on empty stomach Treatment hypoglycemia Instruct to take 15 to 20 g of readily observable carbohydrate (4-6 ounces of fruit juice or regular soft drink, 3 to 4 glucose tablets, 8 to 10 hard candies, 1 tablespoon of honey) recheck glucose in 15 minutes Treatment hypoglycemia -Repeat administration of carbohydrates if glucose not above 70 recheck blood in 15 minutes - if glucose within normal limits, have a snack containing carbohydrate/protein next meal is more than one hour away Hypoglycemia treatment fact 44
45 Pharmacology ATI Glucose increases approximately 40 MG/DL over 30 minutes following ingestion of 10 g of absorbable carbohydrate Hypoglycemia treatment unconscious patient Administer glucagon subq/IM repeat in 10 minutes if still unconscious notify the provider - acute-care nurse administer 50% dextrose if IV access available, consciousness should occur

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture