Medical-Surgical Nursing Final 2023
EXAMS
lispro insulin (humulog) - CORRECT ANSWERS rapid acting insulin
onset of lispro insulin (humolog) - CORRECT ANSWERS under 15 minutes
peak of lispro insulin (humulog) - CORRECT ANSWERS 30 min to 1.5 hours
when to administer lispro insulin (humulog) - CORRECT ANSWERS 0-15 minutes
prior to a meal
regular insulin (Humulin R, Novolin R) - CORRECT ANSWERS short acting insulin
onset of regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 30 min to 60
minutes
peak of regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 2 to 3 hours
when to administer regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 30
minutes before a meal
lente insulin (humulin L) - CORRECT ANSWERS intermediate acting insulin
onset of lente insulin - CORRECT ANSWERS 1 to 2 hours
when to administer lente insulin - CORRECT ANSWERS does not need to be with a
meal
peak of lente insulin - CORRECT ANSWERS 4 to 12 hours
insulin glargine - CORRECT ANSWERS long acting insulin
precautions with insulin glargine (lantus) - CORRECT ANSWERS insulin glargine
cannot be mixed with other insulins!!, the action may be affected in an unpredictable
manner.
onset of insulin glargine - CORRECT ANSWERS 1-1.5 hours
peak of insulin glargine - CORRECT ANSWERS has no peak...lasts 24 hr
,storage for insulin - CORRECT ANSWERS insulin vials should be stored in a
refrigerator or they can be kept at room temperature for up to 28 days. cartridges and
pens should be stored at room temperature and used within 28 days..
glucagon - CORRECT ANSWERS a drug used to treat hypoglycemia. raises blood
glucose levels
side effects of glucagon - CORRECT ANSWERS n/v, hypotension, hypersensitivity, &
hypokalemia
administration of glucagon - CORRECT ANSWERS can be given SQ, IM, or IV. then
as soon as the patient is awake, give the patient some carbohydrate snack
mixing insulin - CORRECT ANSWERS whenever mixing insulin, the short acting
(regular/humilin R) insulin is drawn up first in order to prevent contamination. short
acting is clear insulin and intermediate acting (humilin L/lente) is cloudy, so it is drawn
up clear then cloudy. insulin glargine cannot be mixed with any kind of insulin.
metformin - CORRECT ANSWERS the most common oral hypoglycemic medication
for pre diabetic patients and non insulin dependent type 2 diabetes. is not used to treat
type 1.
administration of metformin - CORRECT ANSWERS taken each day. administer WITH
food in order to prevent GI upset. also take vitamin B12 and folic acid supplements
side effects of metformin - CORRECT ANSWERS GI effects including anorexia, n/v,
HA, abdominal gas/pain, metallic taste, hypoglycemia,
LACTIC ACIDOSIS!! (unexplained muscle aches, fatigue, lethargy and hyperventilation)
*ok for pregnancy
precautions taking metformin - CORRECT ANSWERS needs to be stopped 48 hours
before any type of radiographic test with iodinated contrast dye and can't be resumed
until 48 hours after because this can cause lactic acidosis or ARF. watch renal function
when taking metformin.
when to d/c metformin - CORRECT ANSWERS immediately if unexplained
hypoxemia, dehydration, or signs of lactic acidosis
what foods increase risk of hypoglycemia with oral anti diabetic drugs - CORRECT
ANSWERS celery, coriander, dandelion root, garlic, ginseng
Diabetes mellitus - CORRECT ANSWERS is a systemic, chronic, and progressive
metabolic disease that requires lifelong lifestyle modification. people with DM have the
inability to metabolize carbohydrates, proteins, and fats
,Type 1 DM - CORRECT ANSWERS can be genetic or autoimmune. involves the
destruction of pancreatic beta cells. has no or minimal insulin production.
aka Juvenile onset/ IDDM
Type 2 DM - CORRECT ANSWERS can be genetic and environmental. either d/t
desensitization (limited response by beta cells) or insulin resistance (liver and peripheral
tissues).
aka Adult onset/ NDDM
Type 1: age of onset, symptoms, insulin production, BMI, and insulin mgt - CORRECT
ANSWERS Age: <30 but can occur at any age.
S/sx: abrupt onset, weight loss
Insulin production: None, no prevention.
BMI: usually non-obese
Insulin: dependent
Type 2: age of onset, symptoms, insulin production, BMI, and insulin mgt - CORRECT
ANSWERS Age: peak at 50 yo
S/sx: slow onset, fatigue
Insulin production: low, normal, or high. Preventable.
BMI: 60-80% of type 2 pts are obese
Insulin: 20-30% require
diabetic ketoacidosis - CORRECT ANSWERS a complication of diabetes.. is a lack of
insulin and ketosis.
more common in Type 1
hyperglycemia-hyperosmolar state - CORRECT ANSWERS a complication of
diabetes... is an insulin deficiency and profound dehydration
hypoglycemia - CORRECT ANSWERS a complication of diabetes... is too little insulin,
too little glucose
s/sx of diabetes - CORRECT ANSWERS 3 p's (polyuria, polydipsia, polyphagia),
unintended weight loss, fatigue & weakness, irritability & mood changes, blurred vision,
slow healing sores, acanthuses nigricans, HTN, hyperlipidemia, liver impairment,
frequent infections
complications of DM - CORRECT ANSWERS retinopathy, nephropathy, neuropathy,
CAD/CVD risk of stroke, PVD
acanthosis nigricans - CORRECT ANSWERS skin changes with DM2. skin folds
around neck and armpits
HBA1C pre diabetes - CORRECT ANSWERS 5.7-6.4 %
, HBA1C diabetes - CORRECT ANSWERS > 6.5 %
goal is to be below 7 % for diabetics.
Fasting plasma glucose (FPG) - CORRECT ANSWERS > 126 mg/dl
would be 8+ hours fasting, taken in the morning
Normal FPG for non diabetics - CORRECT ANSWERS < 90
Oral Glucose Tolerance Test (OGTT) - CORRECT ANSWERS > 200 mg/dl after 2
hours
-have patient drink several surgery drinks and take the BG and see how its tolerated?
**check ATI
Random serum glucose - CORRECT ANSWERS > 200 mg/dl
CBC - CORRECT ANSWERS infection, anemia
CMP - CORRECT ANSWERS electrolytes, liver, and renal function
Lipid panel - CORRECT ANSWERS to show CVD risk
urine micro albumin - CORRECT ANSWERS to show protein in the urine, indicates
renal failure
other labs for DM 1 - CORRECT ANSWERS antigens & antibodies for DM 1
Interventions for Pre-diabetics - CORRECT ANSWERS goal is for HBA1c to be < 6
-lifestyle modifications: weight loss of 7 % of body weight, exercise 150 min/week
-meformin therapy IF BMI > 35
-might have blood glucose monitoring
Interventions for Type 1 Diabetics - CORRECT ANSWERS Goal is for HBA1C to be <
7
-lifestyle modification
-insulin therapy is LIFELONG
-basal insulin (short acting-sliding scale and intermediate acting)
-blood glucose monitoring
Interventions for Type 2 Diabetics - CORRECT ANSWERS Goal is for HBA1C to be <
7
-lifestyle modifications
-try oral hypoglycemic agent 1st
-Insulin is possible tmt
-blood glucose monitoring
EXAMS
lispro insulin (humulog) - CORRECT ANSWERS rapid acting insulin
onset of lispro insulin (humolog) - CORRECT ANSWERS under 15 minutes
peak of lispro insulin (humulog) - CORRECT ANSWERS 30 min to 1.5 hours
when to administer lispro insulin (humulog) - CORRECT ANSWERS 0-15 minutes
prior to a meal
regular insulin (Humulin R, Novolin R) - CORRECT ANSWERS short acting insulin
onset of regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 30 min to 60
minutes
peak of regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 2 to 3 hours
when to administer regular insulin (humulin R, Novolin R) - CORRECT ANSWERS 30
minutes before a meal
lente insulin (humulin L) - CORRECT ANSWERS intermediate acting insulin
onset of lente insulin - CORRECT ANSWERS 1 to 2 hours
when to administer lente insulin - CORRECT ANSWERS does not need to be with a
meal
peak of lente insulin - CORRECT ANSWERS 4 to 12 hours
insulin glargine - CORRECT ANSWERS long acting insulin
precautions with insulin glargine (lantus) - CORRECT ANSWERS insulin glargine
cannot be mixed with other insulins!!, the action may be affected in an unpredictable
manner.
onset of insulin glargine - CORRECT ANSWERS 1-1.5 hours
peak of insulin glargine - CORRECT ANSWERS has no peak...lasts 24 hr
,storage for insulin - CORRECT ANSWERS insulin vials should be stored in a
refrigerator or they can be kept at room temperature for up to 28 days. cartridges and
pens should be stored at room temperature and used within 28 days..
glucagon - CORRECT ANSWERS a drug used to treat hypoglycemia. raises blood
glucose levels
side effects of glucagon - CORRECT ANSWERS n/v, hypotension, hypersensitivity, &
hypokalemia
administration of glucagon - CORRECT ANSWERS can be given SQ, IM, or IV. then
as soon as the patient is awake, give the patient some carbohydrate snack
mixing insulin - CORRECT ANSWERS whenever mixing insulin, the short acting
(regular/humilin R) insulin is drawn up first in order to prevent contamination. short
acting is clear insulin and intermediate acting (humilin L/lente) is cloudy, so it is drawn
up clear then cloudy. insulin glargine cannot be mixed with any kind of insulin.
metformin - CORRECT ANSWERS the most common oral hypoglycemic medication
for pre diabetic patients and non insulin dependent type 2 diabetes. is not used to treat
type 1.
administration of metformin - CORRECT ANSWERS taken each day. administer WITH
food in order to prevent GI upset. also take vitamin B12 and folic acid supplements
side effects of metformin - CORRECT ANSWERS GI effects including anorexia, n/v,
HA, abdominal gas/pain, metallic taste, hypoglycemia,
LACTIC ACIDOSIS!! (unexplained muscle aches, fatigue, lethargy and hyperventilation)
*ok for pregnancy
precautions taking metformin - CORRECT ANSWERS needs to be stopped 48 hours
before any type of radiographic test with iodinated contrast dye and can't be resumed
until 48 hours after because this can cause lactic acidosis or ARF. watch renal function
when taking metformin.
when to d/c metformin - CORRECT ANSWERS immediately if unexplained
hypoxemia, dehydration, or signs of lactic acidosis
what foods increase risk of hypoglycemia with oral anti diabetic drugs - CORRECT
ANSWERS celery, coriander, dandelion root, garlic, ginseng
Diabetes mellitus - CORRECT ANSWERS is a systemic, chronic, and progressive
metabolic disease that requires lifelong lifestyle modification. people with DM have the
inability to metabolize carbohydrates, proteins, and fats
,Type 1 DM - CORRECT ANSWERS can be genetic or autoimmune. involves the
destruction of pancreatic beta cells. has no or minimal insulin production.
aka Juvenile onset/ IDDM
Type 2 DM - CORRECT ANSWERS can be genetic and environmental. either d/t
desensitization (limited response by beta cells) or insulin resistance (liver and peripheral
tissues).
aka Adult onset/ NDDM
Type 1: age of onset, symptoms, insulin production, BMI, and insulin mgt - CORRECT
ANSWERS Age: <30 but can occur at any age.
S/sx: abrupt onset, weight loss
Insulin production: None, no prevention.
BMI: usually non-obese
Insulin: dependent
Type 2: age of onset, symptoms, insulin production, BMI, and insulin mgt - CORRECT
ANSWERS Age: peak at 50 yo
S/sx: slow onset, fatigue
Insulin production: low, normal, or high. Preventable.
BMI: 60-80% of type 2 pts are obese
Insulin: 20-30% require
diabetic ketoacidosis - CORRECT ANSWERS a complication of diabetes.. is a lack of
insulin and ketosis.
more common in Type 1
hyperglycemia-hyperosmolar state - CORRECT ANSWERS a complication of
diabetes... is an insulin deficiency and profound dehydration
hypoglycemia - CORRECT ANSWERS a complication of diabetes... is too little insulin,
too little glucose
s/sx of diabetes - CORRECT ANSWERS 3 p's (polyuria, polydipsia, polyphagia),
unintended weight loss, fatigue & weakness, irritability & mood changes, blurred vision,
slow healing sores, acanthuses nigricans, HTN, hyperlipidemia, liver impairment,
frequent infections
complications of DM - CORRECT ANSWERS retinopathy, nephropathy, neuropathy,
CAD/CVD risk of stroke, PVD
acanthosis nigricans - CORRECT ANSWERS skin changes with DM2. skin folds
around neck and armpits
HBA1C pre diabetes - CORRECT ANSWERS 5.7-6.4 %
, HBA1C diabetes - CORRECT ANSWERS > 6.5 %
goal is to be below 7 % for diabetics.
Fasting plasma glucose (FPG) - CORRECT ANSWERS > 126 mg/dl
would be 8+ hours fasting, taken in the morning
Normal FPG for non diabetics - CORRECT ANSWERS < 90
Oral Glucose Tolerance Test (OGTT) - CORRECT ANSWERS > 200 mg/dl after 2
hours
-have patient drink several surgery drinks and take the BG and see how its tolerated?
**check ATI
Random serum glucose - CORRECT ANSWERS > 200 mg/dl
CBC - CORRECT ANSWERS infection, anemia
CMP - CORRECT ANSWERS electrolytes, liver, and renal function
Lipid panel - CORRECT ANSWERS to show CVD risk
urine micro albumin - CORRECT ANSWERS to show protein in the urine, indicates
renal failure
other labs for DM 1 - CORRECT ANSWERS antigens & antibodies for DM 1
Interventions for Pre-diabetics - CORRECT ANSWERS goal is for HBA1c to be < 6
-lifestyle modifications: weight loss of 7 % of body weight, exercise 150 min/week
-meformin therapy IF BMI > 35
-might have blood glucose monitoring
Interventions for Type 1 Diabetics - CORRECT ANSWERS Goal is for HBA1C to be <
7
-lifestyle modification
-insulin therapy is LIFELONG
-basal insulin (short acting-sliding scale and intermediate acting)
-blood glucose monitoring
Interventions for Type 2 Diabetics - CORRECT ANSWERS Goal is for HBA1C to be <
7
-lifestyle modifications
-try oral hypoglycemic agent 1st
-Insulin is possible tmt
-blood glucose monitoring
