Patient Reviews Susan Smith Exam Questions and Answers

Patient Reviews Susan Smith Exam Questions and Answers In a person without diabetes, glucose levels are maintained within the normal range through the action of hormones secreted by the pancreas. One of these hormones enables the transport of glucose into cells to be used for energy. This hormone is: - Answer-Insulin, secreted by the pancreas in response to blood glucose, enables the transport of glucose into cells where it can be used for energy. Glucose (a product of carbohydrate digestion) is the body's preferred source of energy. With insulin in adequate amount, hyperglycemia is avoided. Susan has had type 1 diabetes for two years. Type 1 diabetes involves: -Answer- Persons with type 1 diabetes have absolute insulin deficiency. Immune-mediated or idiopathic conditions have led to pancreatic beta-cell defect or destruction, and total lack of endogenous insulin. With type 1 diabetes, normal blood glucose cannot be maintained without use of exogenous insulin (administered as a medication). Risk for diabetic ketoacidosis (DKA) is high. Type 2 diabetes refers to conditions of insulin resistance with relative insulin deficiency. With type 2 diabetes, normal blood glucose is difficult to maintain. Susan's usual insulin regimen includes insulin glargine. What type of insulin is glarine? - Answer-Insulin glargine is a long-acting insulin. Insulin glargine has an onset of action in 2-4 hours, and effects lasting up to 24 hours or more. It has a relatively non-peaking constant effect. Insulin detemir is another long-acting insulin. Susan also takes insulin lispro, which is what type of insulin? -Answer-Insulin lispro is a rapid-acting insulin. Other rapid-acting insulins include insulin aspart and insulin glulisine . Although individual response varies, insulin lispro begins to lower blood sugar in 15 minutes. Action peaks in 1-2 hours hour and lasts 3-4 hours. Regular insulin -Answer-a short-acting insulin when administered IV has an onset/peak action of 10-30 minutes, and a duration of 30-60 minutes. Only preparation which can be given intravenously. Intermediate-acting -Answer-NPH insulin begins lowering blood sugar after 2 hours, peaks at 4-10 hours, and has effects that last up to about 10-16 hours. NPH insulin cannot not be given IV You read in Susan's medical record that her blood glucose was 650 mg/dL when she was admitted to the Emergency Department (ED). Urine ketones were present in large amount. Susan also presented with other clinical features. What clinical features are commonly associated with diabetic ketoacidosis (DKA) -Answer-polyuria dehydration nausea and vomiting fruity breath odor Kussmaul breathing Susan's medical record reveals that she received insulin in the Emergency Department (ED) to reduce her blood glucose level. She required and received: -Answer-To correct hyperglycemia and stop the breakdown of fats and proteins, insulin is needed. Intravenous administration of regular insulin, a short-acting insulin, ensures the quickest possible response. Regular insulin can be administered intravenously. Regular insulin administered intravenously has an onset/peak action of 10-30 minutes, and a duration of 30-60 minutes