Exam (elaborations)
NURS 317 Final Exam With Correct Answers.
- Course
- Institution
NURS 317 Final Exam With Correct Answers.
[Show more]
Content preview
NURS 317 Final Exam With CorrectAnswers.
Insulin - ANSWER- Prototype drug: human regular insulin (Humulin R, Novolin R)
**Mechanism of action: to promote entry of glucose into cells
-to promote the entry of glucose, amino acids, and potassium into cells
-to promote protein synthesis, glycogen formation and storage, and fatty acid storage
-to conserve energy stores by promoting the utilization of glucose for energy needs and
inhibiting gluconeogenesis.
**Primary use: short-acting insulin, with an onset of 30-60 minutes, a peak effect at 2-3
hours, and a duration of 5-7 hours to quickly decrease blood glucose
Also for emergency management of ketoacidosis
**Indication for use :
-monotherapy to lower blood glucose levels in type 1 diabetes
-combination with other agents in type 2 diabetes
-emergency management of diabetic ketoacidosis
-gestational diabetes
Signs of hypoglycemia - ANSWER- tachycardia, confusion, sweating, drowsiness,
convulsions, coma, death
What is used to treat hypoglycemia? - ANSWER- wwPrototype drug: Glucagon
(GlucaGen)
Mechanism of action: increases glucose levels by increasing glycogenolysis. Stimulates
uptake of amino acids.
Primary use: emergency treatment of hypoglycemia, used for radiographic studies to
relax GI tract smooth muscle
Also for emergency management of ketoacidosis
Adverse effects: Well tolerated, other effect include
nausea, vomiting, hypersensitivity reaction, transient changes in blood pressure,
tachycardia, hyperglycemia, hypokalemia
Nurse responsibility for Insulin - ANSWER- -Hold insulin dose if blood sugar is less than
70 mg/dL and report to the health care provider.
-Continue to monitor periodic lab work:
CBC, electrolytes, glucose, A1C level, lipid profile, osmolality, hepatic- and renal-
function studies.
-Assess for symptoms of hypoglycemia, especially around the time of insulin peak
activity.
- Monitor blood-glucose levels more frequently during periods of illness or stress.
-Encourage increased physical activity but monitor blood-glucose levels before and after
exercise, and begin any new or increased exercise routine gradually.
-Rotate insulin administration sites weekly.
,Change insulin pump subcutaneous catheters every 2 to 3 days to prevent infections at
the site of insertion.
-Ensure proper storage of insulin to maintain maximum potency.
-Check urine for ketones if blood glucose is over 300 mg/dL.
Biguanides - ANSWER- -Metformin (Glucophage) only drug in this class
-Decreases hepatic production of glucose (gluconeogenesis) and reduces insulin
resistance
-Does not promote insulin release from pancreas
-Most side effects are minor and GI-related
anorexia, nausea, and diarrhea
-New extended-release formulation of metformin (Glumetza) allows for once-daily
dosing
Rapid insulin - ANSWER- Aspart (Novolog)
Intermediate - ANSWER- NPH
Long Lasting - ANSWER- Lantus
Metaformin - ANSWER- **Mechanism of action:
decrease the hepatic production of glucose and reduce insulin resistance in target cells
Indication for use: Treatment of type 2 diabetes
also used to treat women with polycystic ovary syndrome
**Adverse effect:
The most common adverse effects are GI related and include nausea, vomiting,
abdominal discomfort, metallic taste, diarrhea, and anorexia.
It may also cause headache, dizziness, agitation, and fatigue.
Unlike the sulfonylureas, metformin rarely causes hypoglycemia or weight gain.
Alpha cells of Pancreas - ANSWER- Glucagon
Beta Cells of Pancreas - ANSWER- Insulin and amylin
Delta cells - ANSWER- somatostatin
PP cells - ANSWER- Pancreatic polypeptide
Glucagon - ANSWER- - produces an increase in blood glucose
-causes cells to release stored food into the blood
-Increase transport of amino acids into liver
-Stimulates amino acid conversion into glucose
-Gluconeogenesis process
If high blood glucose - ANSWER- Pancreas releases insulin --> cells pick up glucose
from blood and liver produces glycogen---> blood glucose drops
, If low blood glucose - ANSWER- Pancreas produces glucagon---> liver breaks down
glycogen--> blood glucose rises
Action of insulin and glucagon on glucose - ANSWER- Glucose transport
Glycogen synthesis
Gluconeogenesis
Action of insulin and glucagon on protein - ANSWER- Amino acid transport
Protein synthesis
Protein breakdown
Action of insulin and glucagon on fat - ANSWER- Fatty acid and triglyceride synthesis
Fat storage in adipose tissue
Amylin - ANSWER- Increase in response to nutritional stimuli
Inhibits gastric emptying and glucagon secretion
slows glucose absorption in small intestine
suppresses glucagon secretion
Somatostatin - ANSWER- Suppresses insulin and glucagon secretion
Decreases GI activity after ingestion of food
Gut-derived hormones - ANSWER- Incretin effect
Increase insulin release after oral nutrient load
Epinephrine - ANSWER- Maintains blood glucose levels during periods of stress
Causes glycogenolysis in liver
Inhibits insulin release from beta cells
Important homeostatic mechanism during periods of hypoglycemia
Growth hormone - ANSWER- Decrease cellular uptake of and use of glucose
Glucocorticoid hormone - ANSWER- Stimulate gluconeogenesis
Decrease tissue use of glucose
Type 1 Diabetes - ANSWER- Caused by an absolute lack of insulin secretion due to
autoimmune destruction of pancreatic beta cells
causes the necessity of exogenous insulin to regulate blood sugar
-Diabetes mellitus (DM) type 1 commonly occurs before age 20 with abrupt onset of
polyuria, polyphagia (increased hunger), and polydipsia(increased thirst)
-Glycosylated hemoglobin, also called hemoglobin A1c, will be elevated in uncontrolled
diabetes mellitus of any type
-Clients with type 1 diabetes mellitus require exogenous insulin
they have absolute lack of their own secretion
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Divinehub. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
77254 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now