NUR2474 Pharmacology for Professional Nursing Final Examination Blue Print Questions and answers

NUR2474 Pharmacology for Professional Nursing – Examination Blue Print – Final Exam Insulin: DM 1, DM 2, Gestational Diabetes HYPOGLYCEMIA IS A DANGEROUS ADVERSE EFFECT AND HIGH PRIORITY FOR TREATMENT 1. What types of insulin are ordered before meals and at bedtime? Lispro and Regular are not ordered before bedtime; Lispro and Regular are usually given before meals; Lantus is given before bedtime; In the elderly especially, lantus is sometimes split into a morning and evening dose. Why? SUGAR DROPS OVERNIGHT and this can be DANGEROUS so NO NPH at bedtime; NPH is often given only in the morning. 2. What type of insulin is sometimes given at bedtime, has the longest duration of all the insulins, CANNOT BE MIXED WITH OTHER INSULINS, and for elderly patients is often split into two doses (one in the morning and one at bedtime)? Insulin Glargine (Lantus) is usually given once a day at bedtime. Elderly individuals often have their dose split in two and are administered one dose in the morning and one dose at night; In addition, sometimes insulin lispro is given in a sliding scale with a snack in the evening. It doesn’t last throughout the night-that’s what we want to avoid. *Insulin aspart protamine in combo with insulin aspart would NOT be given in the evening, as it lasts too long. *NPH would peak at exactly the WRONG TIME. Do not give that one at bedtime. Why is a nurse concerned for a beta-blocker/insulin combination? Beta Blockers can mask some of the symptoms of hypoglycemia What do you assess for? What symptoms could be concealed by taking a beta blocker while on insulin?  Symptoms of hypoglycemia:  Feeling shaky.  Being nervous or anxious.  Sweating, chills and clamminess.  Irritability or impatience.  Confusion.  Fast heartbeat.  Feeling lightheaded or dizzy.  Hunger. You will need to know the following chart: