NURS 317 Final Exam Questions and
Correct Answers/ Latest Update / Already
Graded
Insulin
Ans: Prototype drug: human regular insulin (Humulin R,
Novolin R)
**Mechanism of action: to promote entry of glucose into cells
-to promote the entry of glucose, amino acids, and potassium
into cells
-to promote protein synthesis, glycogen formation and
storage, and fatty acid storage
-to conserve energy stores by promoting the utilization of
glucose for energy needs and inhibiting gluconeogenesis.
**Primary use: short-acting insulin, with an onset of 30-60
minutes, a peak effect at 2-3 hours, and a duration of 5-7 hours
to quickly decrease blood glucose
Also for emergency management of ketoacidosis
**Indication for use :
-monotherapy to lower blood glucose levels in type 1 diabetes
-combination with other agents in type 2 diabetes
-emergency management of diabetic ketoacidosis
-gestational diabetes
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Signs of hypoglycemia
Ans: tachycardia, confusion, sweating, drowsiness,
convulsions, coma, death
What is used to treat hypoglycemia?
Ans: wwPrototype drug: Glucagon (GlucaGen)
Mechanism of action: increases glucose levels by increasing
glycogenolysis. Stimulates uptake of amino acids.
Primary use: emergency treatment of hypoglycemia, used for
radiographic studies to relax GI tract smooth muscle
Also for emergency management of ketoacidosis
Adverse effects: Well tolerated, other effect include
nausea, vomiting, hypersensitivity reaction, transient changes
in blood pressure, tachycardia, hyperglycemia, hypokalemia
Nurse responsibility for Insulin
Ans: -Hold insulin dose if blood sugar is less than 70 mg/dL and
report to the health care provider.
-Continue to monitor periodic lab work:
CBC, electrolytes, glucose, A1C level, lipid profile, osmolality,
hepatic- and renal-function studies.
-Assess for symptoms of hypoglycemia, especially around the
time of insulin peak activity.
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- Monitor blood-glucose levels more frequently during periods
of illness or stress.
-Encourage increased physical activity but monitor blood -
glucose levels before and after exercise, and begin any new or
increased exercise routine gradually.
-Rotate insulin administration sites weekly.
Change insulin pump subcutaneous catheters every 2 to 3 days
to prevent infections at the site of insertion.
-Ensure proper storage of insulin to maintain maximum
potency.
-Check urine for ketones if blood glucose is over 300 mg/dL.
Biguanides
Ans: -Metformin (Glucophage) only drug in this class
-Decreases hepatic production of glucose (gluconeogenesis)
and reduces insulin resistance
-Does not promote insulin release from pancreas
-Most side effects are minor and GI-related
anorexia, nausea, and diarrhea
-New extended-release formulation of metformin (Glumetza)
allows for once-daily dosing
Rapid insulin
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Ans: Aspart (Novolog)
Intermediate
Ans: NPH
Long Lasting
Ans: Lantus
Metaformin
Ans: **Mechanism of action:
decrease the hepatic production of glucose and reduc e insulin
resistance in target cells
Indication for use: Treatment of type 2 diabetes
also used to treat women with polycystic ovary syndrome
**Adverse effect:
The most common adverse effects are GI related and include
nausea, vomiting, abdominal discomfort, metallic taste,
diarrhea, and anorexia.
It may also cause headache, diiness, agitation, and fatigue.
Unlike the sulfonylureas, metformin rarely causes hypoglycemia or
weight gain.zz
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