Rasmussen College – Professional Nursing 2/PN2 Exam 3 Study Guide.

ketoacidosis and maintain life o Onset is frequently in childhood; usually ages 10-15 o This is forever o First sign is often Diabetic Ketoacidosis _ Type 2 is a combination of insulin resistance and inadequate insulin secretion to compensate o Often linked to obesity, sedentary lifestyle, and heredity o Onset is predominately in adulthood, generally after the age of 35 o Usually controlled with diet, exercise and oral hypoglycemics o Usually found by accident; the patient keeps coming back for a wound that wont heal or repeated vaginal infections _ Signs and Symptoms: o Both Type 1 and Type 2: 3 Ps: polyuria, polydipsia, and polyphagia o Fatigue o Increased frequency of infections _ Type 1: o Weight loss o Bed-wetting, blurred vision o Enuresis (involuntary urination, especially in children at night) in children, nocturia in adults o Abdominal pain o Rapid onset _ Type 2: o Weight gain, visual disturbances o Slow onset; usually around 40 years old o Fatigue and malaise o Recurrent vaginal yeast _ Diagnostics: o The criteria for diagnosis must include two findings on separate days must also be the test plus a random glucose greater than 200 mg/dL o Fasting blood glucose level above 126 mg/dL o Oral glucose tolerance test: 2- hour glucose values greater than 200 mg/dL o Glycosylated hemoglobin (A1C) greater than 6.5% _ Medications: _ Insulin: o Rapid-acting insulin: lispro, aspart, glulisine _ Given before meals _ Onset: 5-15 minutes _ Peak: 30-90 minutes _ Duration: les than 5 hours _ Given subcutaneously _ Given in conjunction with intermediate- or long-acting insulin to provide control between meals and at night _ Because of quick onset, patient must eat immediately o Short-Acting Insulin: regular _ Given approximately 30-60 minutes before meals _ Onset: 30 minutes 1 hour _ Peak: 2-3 hours _ Duration: 5-8 hours _ This is our clear insulin _ Given alone or in combination with longer-acting insulin _ Given for sliding scale coverage _ Can be given subcutaneously, IV, or IM ***only insulin that can be given IV _ U-500 is for patient who is insulin resistant, never given IV _ U-100 is for most patients and can be given IV o Intermediate-Acting insulin: NPH, Novolin N _ Hypoglycemia tends to occur in mid to late afternoon _ Onset: 2-4 hours _ Peak: 4-10 hours _ Duration: 10-16 hours _ This is our cloudy insulin _ Given for control between meals and at night _ Contains protamine (a protein), which causes a delay in the insulin absorption or onset and extends the duration of action of the insulin _ Give NPH insulin subQ only can be mixed with short-acting or rapid-acting o Long-Acting Insulin: glargine (Lantus), detemir (Levemir) _ CANNOT be diluted or mixed with any other insulin _ Usually given at bedtime _ Onset: 2-4 hours _ No peak _ Duration: 24 hours _ Detemir may be given twice a day, dependent on dose _ Only given subQ [Show less]

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