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NRpo601poFINALpoEXAMpoSTUDYpoGUIDENR 601 Final Exam Study Guide (V2) / NR601
Final Exam Study Guide (NEW, 2021/2022)
Chamberlain College Of Nursing
MedicationpoSidepoEffects
-Typepo1:
Hypoglycemiapoispoapocommonpooccurrencepoinpopatientspowithpotypepo1poDMpoandpo
occurspoforpoapovarietypoofporeasons:poexcessivepoexogenouspoinsulin,pomissedpomeal
spoorpoinadequatepofoodpointake,poexcessivepoexercise,poalcoholpoingestion,podrugpoi
nteractions,poorpodecreasespoinpoliverpoorpokidneypofunction.poSignspoandposymptoms
:podiaphoresis,potachycardia,pohunger,poshakiness,poalteredpomentationpo(rangingpof
rompoanpoinabilitypotopoconcentratepotopofrankpocoma),poslurredpospeech,poandposeiz
ures.poThepoADApoclassifiespohypoglycemiapoaspoapoplasmapoglucosepolevelpoofpo<po54p
asposerious,poclinicallyposignificantpohypoglycemia.poApobloodpoglucosepolevelpoofpo70
o
po ispoconsideredpoapothresholdpolevelpothatporequirespointervention.poExamplespoofpo
appropriatepofoods:po#1pochoice:popurepoglucose,po½pocuppofruitpojuice,po6ozporegular
po sodapo(notpodietpoorposugarless),po1pocuppomilk,poorpoglucosepotabs.poCandypoispoonl
ypoapolastporesort.poRecheckpoglucosepo15pominutespoafterpotreatment.poAdditionalpoc
arbspocanpobepogivenpoifpoglucosepoispostillpolesspothanpo70
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, -Typepo2:
Metforminpocanpocause:pohypoglycemiapoesppoinpoolderpoadults,poadverseporeactions
suchpoaspoGIpodisturbancespoandpometallicpotaste,poandpoispocontraindicatedpoinporen
po
alpodiseaseposopoassessporenalpofunctionpopriorpotopoprescribing.
- MetforminpoalsopohaspoapoboxedpowarningpoinpoitspoFDA-
approvedpoprescribingpoinformationpoforpolacticpoacidosis,poalthoughpothisposi
depoeffectpoispoveryporare.poMetforminposhouldpobepodiscontinuedpo24potopo48
po hourspobeforepodiagnosticpoandposurgicalpoprocedurespoduepotopotheporiskpoo
fpodecreasedpokidneypofunction,poandpoitspoadministrationposhouldponotpobepo
resumedpoforpoatpoleastpo6pohourspoafterpothesepoprocedurespoorpountilpothepo
patientpoispoadequatelypohydrated.poInitialpodosingpoispo500pomgpooncepoapoda
ypowithpobreakfastpoorpodinnerpoforpo1poweek,pothenpotwicepodailypowithpobrea
kfastpoandpodinner.poSeveralpoweekspoofpotherapypomaypobeponeededpotopoac
hievepomaximumpoeffectspoofpothepogivenpodose.poCommonpoadverseporeacti
onspoincludepodiarrhea,ponausea,poanorexia,poandpoabdominalpodiscomfort,po
whichpousuallyporesolvepowithpoapogradualpoincreasepoofpodosage.poMetformi
npohaspobeenposhownpotopocausepodecreasedpovitaminpoB12poabsorption,poand
po patientspoonpolong-
termpometforminpotherapyposhouldpoundergopoperiodicpotestingpoforpoB12podef
iciency,poespeciallypoifpothepopatientpocomplainspoofpoperipheralponeuropathy.p
Atpothepomaximumpodose,pothepomonthlypocostpoofpometforminpoinpothepoUni
o
tedpoStatespoispoapproximatelypo$4poonpomanypogenericpoformularies.poMetfo
rminpoispocurrentlypofoundpoinpo20pocombinationpoformulationspowithpootherp
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, omedications.
*Forpootherpononinsulinpoagentpoadverseporeactionsposeepopgpo929poDunphypobook*
SINGLE-DOSEpoTHERAPY
SinglepoInjection
• Intermediatepoorpolong-
actingpoinsulinpowithpoorpowithoutporegularpoinsulinpoinpothepomorningpoor
poIntermediatepoorpolong-actingpoinsulinpoatpobedtime
• RecommendpoatpoapominimumpoSMBGpoinpothepomorningpoandpoatpobedtime
CONVENTIONALpoSPLIT-DOSEpoTHERAPY
TwopoInjections
• MixturepoofpoNPHpoandporegularpoinsulinpoinpothepomorningpoandpoevening
• RecommendpoatpoapominimumpoSMBGpobeforepoeachpodosingpoandpoatpobedtime
INTENSIVEpoINSULINpoTHERAPY
3
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ThreepoInjections
• NPHpoandporegularpoinsulinpoinpothepomorning;poregularpoinsulinpoatpodinner;poNPHpoinsulinpoatp
obedtime
• Monitorpoforpoincreasedporiskpoofpohypoglycemicpoep
isodespoFourpoInjections
• Regularpoorpolispropoinsulinpobeforepomealspoandpolong-
actingpoinsulinpotopomaintainpobasalpoinsulinpolevels
• Monitorpoforpoincreasedporiskpoofpohypoglycemicpoepisodes
Weekpo5:poGlucosepometabolismpodisorders
TypespoofpoDM
1. Typepo1-
severepoinsulinpodeficiencyporesultingpoinporeductionpoorpoabsencepoofpofunc
po
tioningpobetapocellsp o inpothepopancreaticpoisletspoofpoLangerhans.poThispolead
spotopohyperglycemiapoduepotopoalteredpometabolismpoofpolipids,pocarbs,poand
proteins.poInitialpos/spoofpohyperglycemia.poSubjectivepofindings-
po
polyuria,popolydipsia,ponocturnalpoenuresispoandpopolyphagiapowithpoparado
po
xicalpoweightpoloss,povisualpochangespoandpofatigue.poObjective-
dehydration(poorposkinpoturgorpoandpodrypomucous),powtpolosspodespiteponor
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