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kyleannkelsey
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What is the onset, peak and duration for Rapid acting insulins?
- Onset: 5- 15 min
- Peak: 45 - 90 min
- DOA: 3 - 4 hr
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What is the onset, peak and duration for Regular insulin?
- Onset: 30 - 60 min
- Peak: 2 - 4 hr
- DOA: 5 - 7 hr
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What is the onset, peak and duration for NPH?
- Onset: 1 - 2 hr
- Peak: 6 - 14 hr
- DOA: 10-16 hr
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What is the onset, peak and duration for Basal insulin?
- Onset: 2-4 hr
- Peak: Peakless
- DOA: 24 hr
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What is the goal preprandial glucose?
70-130
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What is the goal bedtime glucose?
110-150
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Describe the schedule for a conventional insulin therapy:
- Before breakfast: NPH and Rapid (2/3 daily insulin)
- Before Dinner: NPH and Rapid (1/3 daily insulin)
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Describe the schedule for a Method 2 Intensive insulin therapy:
- Before breakfast: NPH and Rapid (2/3 daily insulin)
- Before Dinner: Rapid (1/6 daily insulin)
- Bedtime: NPH (1/6)
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Describe the schedule for a Method 3 Intensive insulin therapy:
- Before breakfast: Rapid (17% daily insulin)
- Before Lunch: Rapid (16% daily insulin)
- Before Dinner: Rapid (16% daily insulin)
- Bedtime: NPH (50%)
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When using method 3 (intensive) and the AM glucose is high, what action do we take?
Increase the basal
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What are the S/S of overinsulinemia?
- Weight gain over the past several months
- Frequent hypoglycemic reactions.
- "Brittle" control, where blood glucose concentrations
- Normal A1C levels indicate that mean glucose concentrations are within the normal range even though numerous high glucose levels are recorded
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How do you treat overinsulinemia?
Reduce dose by 10%
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What are the S/S of Hypoglycemia?
- Blurred vision, generalized sweating, tremor, hunger, sweaty palms, a cold feeling, headache, and palpitation. Nightmares and night sweats
- leads to: reduced cerebral function manifested by lethargy, confusion, agitation, and nervousness
- Ultimately, convulsions, with stupor, and coma can occur.
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How do you treat Hypoglycemia?
- Rule of 15:
- If glucose < 70 mg/dL, treat with 15 gm of rapidly absorbed CHO (½ cup of orange juice, non-diet soda, or 3-4 glucose tablets)
- Check glucose again in 15 minutes; if still < 70, eat another 15 gm CHO and re-check glucose in 15 minutes
- Repeat as needed until glucose is in goal range
- If a meal is not scheduled in the next hour or so, a small snack consisting of complex
- For the unconscious patient, a 1 mg dose of glucagon can be given SQ, IM, or IV. Patient should be placed face down to protect the airway if vomiting occurs.
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What is the general method of sliding scale insulin?
1 to 2 U of regular insulin are administered for every 30 to 50 mg/dL above a predetermined target glucose concentration
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