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Summary NUR 2474 - Test 3 Review (Module 7 and 8).
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NUR 2474 - Test 3 Review (Module 7 and 8)/NUR 2474 - Test 3 Review (Module 7 and 8).
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NUR 2474 - Test 3 ReviewGeneral tips for studying:
1. Memorize names of medication categories from the presentation
2. Memorize key drugs from categories above (there are many questions with specific drug names)
3. Use generic names
4. When reviewing particular drugs note category, indications, common side effects, toxicity signs (if
applicable), reversal agents, mechanism of action (e.g. agonizing or antagonizing which receptors)
5. Read question instructions (there will be ‘select all that apply’ questions)
Topics to review:
------------------------------------------------MODULE 7---------------------------------------------------
1. What to monitor in patients on insulin therapy, NPO status and insulin therapy If
you give insulin and they don’t want to eat it is a big deal- hypoglycemia
If you have a patient who is NPO and they just received insulin and their blood sugar drops
below 80 that is a cause of concern.
Monitor Blood sugar level, if it's 60-80, it’s an emergency situation and GLUCAGON must be administered
2. Signs of hypoglycemia
Antidiabetic drugs- know signs and symptoms of hypoglycemia- agitation, tremor, confusion,
sense of hunger, flushing, irritable, tachycardia, palpitations, sweating (diaphoresis), and
nervousness, headache, drowsiness, and fatigue.
Glucagon given for treatment of severe hypoglycemia. Check blood glucose first and then
treat it. “Cold and clammy give some candy.”
3. Memorize insulin names by categories (rapid, short, intermediate, long-acting, and
mixed) Know insulin types- Long-acting will last the whole day in your system.
INSULIN WHAT I NEED TO KNOW AS A BRAND NEW NURSE
● Rapid Acting Insulin
Common examples: Aspart (NovoLog), Lispro (Humalog), Glulisine (Apidra)
*Onset: 5-15 minutes. Administer with meals. DO NOT administer unless meal is readily available.
* Peak: 1-3 hours, Duration: 3-5 hours.
* Monitor for hypoglycemia, hypokalemia, lipodystrophy.
* Always have oral carbohydrate available.
*May be given as a short-term IV therapy with very close monitoring
● Short Acting Insulin (Regular)
Common examples: Humulin R, Novolin R,
* Onset: 30 minutes to 1 hour, Peak: 2-4 hours, Duration: 6-8
hours. * Used for dosing patients with Sliding Scale
* Can be administered IVP or via continuous infusion.
* Monitor for hypoglycemia, hypokalemia, lipodystrophy. *
Always have oral carbohydrate available.
● Intermediate Acting Insulin
Common examples: Isophane suspension (NPH, Humulin N, Novolin N)
* Onset: 1-1.5 hours, Peak: 6-12 hours, Duration: 18-24 hours.
,* Cloudy suspension. Can mix with Regular or Rapid Acting Insulin, draw
up clear (Regular or Rapid Acting) then cloudy (NPH), “Clear to Cloudy.”
* Monitor for hypoglycemia, hypokalemia, lipodystrophy.
* Always have oral carbohydrate available.
● Long-Acting Insulin Common
examples: Glargine (Lantus)
* Onset: 2-4 hours. No Peak, Duration: 24 hours.
* Once daily Subq injection provides 24 hour coverage.
* No peak, insulin delivered at steady level, less risk of hypoglycemia.
* Monitor for hypoglycemia, hypokalemia, lipodystrophy
* Always have oral carbohydrate available.
*DO NOT mix with any other insulin
● Combination Insulin (Pre-mixed)
Common examples: Humulin 70/30,
NovoLog Mix 70/30 Humalog Mix 75/25,
Humalog Mix 50/50,
* Intermediate Acting Insulin combined with either Rapid Acting or Short
Acting (Regular) Insulin.
* Onset and Peak dependent on whether combined with a Rapid Acting or
Short Acting Insulin. All provide 24 hour duration.
* Monitor for hypoglycemia, hypokalemia, lipodystrophy.
, Need Food Coverage with Insulin are Lispro and Aspart (Rapid and Regular insulin)
Levemir/Lantus Long Acting (Once a day at bedtime)
****Always check the insulin client (70/30) first in assessment as they might go into hypoglycemia.
Normal glucose level (70-99). Even before a vancomycin patient.
4. How and when to administer different types of insulin (rapid- and short-acting before meals,
intermediate twice a day, long-acting at night)
Regular insulin is the only insulin that can be given other than
subQ Syringes have to match your concentration grading.
NPH insulin is cloudy
What insulin for food coverage- lispro aspart, rapid acting or regular for
meals Long acting insulin at bedtime once per day
!!Rapid acting and regular must follow up with food!!
Rapid and short-acting before meals, intermediate twice a day, long-acting at night)
Long-acting insulin (Lantus/Levemir) are given once per day at bedtime
5. Know beta-blockers. Beta-blockers and hypoglycemia
Beta blockers- ends in lol- most significant side effect bradycardia (Low HR), effects
asthma- no beta blockers for asthma may cause bronchospasms
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