Insulin/Diabetes

Vocabulary flashcards covering blood glucose monitoring, diabetes types, insulin administration, subcutaneous injections, and related assessments based on lecture notes.

Blood Glucose Monitoring

Required by all diabetics; also by some hospitalized clients due to stress, surgical procedures, or medication side effects; and by clients with enteral feedings (every 6 hours).

Diabetes

A condition affecting the body's ability to produce insulin in the pancreas.

Type 1 Diabetes

An autoimmune condition where beta cells are damaged, leading to no insulin production; insulin dependent and often diagnosed in childhood.

Insulin Dependent

Always requires insulin.

Type 2 Diabetes

A condition where cells become resistant to insulin's effects, often correlated with obesity and inactivity, accounting for 95% of cases.

Gestational Diabetes

Diabetes that occurs during pregnancy.

Prediabetic

A blood glucose level higher than normal but not high enough to diagnose diabetes.

Normal Blood Glucose Range (Adult)

70-110 mg/dL.

Blood Glucose Monitoring Testing Procedure

Prepare monitor, warm skin if necessary, clean and dry skin, puncture with lancet, gently squeeze for second drop (do not milk or massage), wipe away first drop, collect second drop.

Infant Blood Glucose Monitoring Site

Outer aspect of the heel (medial or lateral plantar surface) to avoid nerve damage.

Normal Blood Glucose Range (Newborns)

40-60 mg/dL.

Hyperglycemia

Blood glucose level above 110 mg/dL, with symptoms including dry mouth, increased thirst, fatigue, abdominal pain, frequent urination, and fruity breath odor.

Hypoglycemia

Blood glucose level below 70 mg/dL, with symptoms including sweating, nausea, anxiety, hunger, confusion, fatigue, shortness of breath, rapid heartbeat, difficulty speaking, dizziness, lightheadedness, shakiness, and nervousness.

Ketoacidosis

Occurs when fats are broken down for energy, producing ketones that build up in the blood if kidneys can't eliminate them; life-threatening, requires medical care.

Ketoacidosis Symptoms

Fruity smelling breath, nausea, vomiting, decreased level of consciousness, dry mouth.

Ketoacidosis Treatment

IV insulin, ICU monitoring, hourly blood glucose checks.

Urinalysis for Ketones

Checked if blood glucose is greater than 240 mg/dL, indicating potential ketoacidosis.

Insulin Syringes

Always measured in UNITS (not mL), have orange caps, and are available in different sizes like 30, 50, and 100 units.

High Alert Medication (Insulin)

Requires a 2 RN check due to high risk.

Insulin Pen Priming

Priming the needle with 2 units before use to ensure medication (not air) is injected.

NPH Insulin Preparation

Requires rolling the vial to mix the suspension.

Mixing Insulins (General Rule)

Clear insulin should be drawn before cloudy insulin; short-acting before long-acting.

Long-Acting Insulin (Mixing)

Never mixed with other insulins.

Mixing Rapid-Acting and Intermediate-Acting Insulins

Draw up rapid-acting insulin first, then intermediate-acting; never push rapid-acting insulin into the intermediate-acting vial.

Sliding Scale Insulin

Insulin dosage based on current blood glucose levels, with specific instructions for different ranges.

Subcutaneous Injection Sites

Adipose tissue areas like the outer lateral aspect of the upper arm, abdomen (2 inches from umbilicus), anterior upper thighs, upper back, and upper ventral gluteal area.

Subcutaneous Injection Site Considerations

Avoid bruised, open, scarred, or bony areas; rotate sites within the same anatomical region for consistent absorption; pinch skin and wait 10 seconds before removing the needle.

Subcutaneous Needle Gauge and Length

Typically 25-31 gauge, ½ - 5/8 inch.

Subcutaneous Injection Angle

45-90 degrees (45 for clients with less adipose tissue, 90 for adults or obese clients).

Subcutaneous Injection Max Volume (Adults/Children)

Max 1 mL for adults, 0.5 mL for children.

Subcutaneous Injection Procedure Steps

Don gloves, cleanse site, pinch skin, insert needle at appropriate angle, release tissue, inject medication, wait 10 seconds, remove needle, apply gauze (do not massage), engage safety, dispose in sharps.

Breast and Lymphatics Assessment

Checking for self-breast exams, cracked nipples (breastfeeding), enlarged lymph nodes, lymphedema.

Conditions Related to Breast/Lymphatics

Breast cancer, breast reduction/enlargement, lymphedema, lymphadenitis.

Rectal and Genitourinary Assessment

Checking for dysuria, frequency, burning, last menstrual cycle, self-testicular exam, and tracking urine output.

Normal Urine Output

1 mL/kg/hr or a minimum of 30 mL/hr.

Conditions Related to Rectal/Genitourinary

UTI, incontinence, BPH (Benign Prostatic Hyperplasia), dysmenorrhea.