Meal plans for diabetics focus on _____, _____, and _____.
___________ acting insulin may be split into two doses/day and produces a basalar effect. It's duration is 16-20hours with a peak of 4-12 hours.
Novolin L + Novolin N
A diabetic caloric intake should include ___-___% carbohydrates, 20-30% _____ and ___-___% _____.
Short acting or Regular insulins have an onset of ____-____hr, a peak of ___-___ hrs and a duration of 4-6 hours.
Humalog R and Novolin R
Cholesterol intake should be limited to less than ___mg/day.
Which fiber (soluble or insoluble) is better and why?
Solubule because it lowers glucose and lipid levels and slows gastric emptying, slowing absorption.
at least 25g of fiber should be ingested daily
T or F
Clients with diabetes should exercise whenerver they have time and for as long as they want.
False- they should do the same exercise, at the same time everyday for the same duration.
When rehydrating a DKA patient, infuse .5-1L/hr of .9NaCl for 2-3 hrs then .45/NaCl.for a few liter/hrs, finishing up with ______ when the blood sugar reaches 300mg/dL to prevent fast decline in blood glucose.
Which (Human or animal) sources have the shorter duration of action?
Animal derived insulin although effective still triggers an immune response slowing the availibilty.
Clients taking this type of insulin should not postpone eating for more than ____-____mins to avoid hypoglycemia.
Rapid acting-humalog, novulog or apidra
This type of insulin is the only one approved for IV administration.
These insulins have a pH of 4 and cannot be mixed with any other insulin.
Long acting- lantus and levemir
Morning hyperglycemia results from nocturnal surges of _______ hormone secretion.
Basal rate of insulin is usually between ___ to___ units/hr.
.5 to 2 units per hour
What are the 1st gen. sulfonylureas?
What are the three main causes of DKA?
decreased or missed dose of insulin
illness or infection
undiagnosed or untreated diabetes
These S/S are indictative of ________ and ________.
Polyuria, polydipsia, blurred vision, weakness, H/A, orthostatic hypotension, rapid weak pulse, anorexia, nausea, vomiting, abdominal pain, fruity breath, lethargia, and kussmauls respirations.
2nd gen. Sulfonylureas are Glipizide,Glyburide, and amaryl. What do they do?
They stimulate the beta cells to secrete more insulin
May improve the binding of insulin to insulin receptors
Increase the number of insulin receptors
This drug works by inhibiting the production of glucose by the liver, increases the cellular sensitivity to insulin, decreases the hepatic synthesis of cholesterol.
Metformin with glyburide (Glucovance)
This inhibitor must be taken with the first bite of food to be effective. It delays absorption of complex carbs, slowing the entry of glucose into the blood stream.
If a vial of insulin will be used within ___ month(s) it can be kept at _____ temp.
A patient with dehydration caused by DKA(polyuria) can loose up to ___ liters of fluid in a 24hr period. They also loose large amounts of these electrolytes, ____ and _____.
sodium and potassium.
Treatment of DKA with an insulin drip should not be stopped till the client can _____ and ______ insulin therapy has been resumed.
T or F
When mixing an insulin drip, the line should be primed and the first 50ml should be discarded.
T- insulin molecules adhere to the IV adminstration set, so the first 50 ml can be an ineffective concentration.