Insulin

Question 1

Why Oral Insulin is Impossible

Answer 1

• Insulin is a peptide hormone broken down by gastric acid and digestive enzymes

Question 2

Nursing Considerations for Hypoglycemic Administration

Answer 2

• Dietary status changes
• Appetite and tolerance
• Meal readiness
• Enteral feeding

Question 3

Rapid Acting Insulin

Answer 3

• Bolus
• Clear
• Injected 0-15 min before meal
• Onset 10-15 min
• Duration 3.5 - 5h

Question 4

Short Acting Insulin

Answer 4

• Bolus
• Clear
• Injected 30-45 min before meal
• Onset 30 min
• Peak 2-3h
• Duration 5-8h

Question 5

Intermediate Acting Insulin

Answer 5

• Basal
• Cloudy
• Injected BID , no consideration for meals
• Onset 2-4 h
• Peak 4-10h
• Duration 12-18h

Question 6

Long Acting Insulin

Answer 6

• Basal
• Cloudy
• Cannot be mixed with others
• Injected daily
• Onset 2-4h
• Peak none
• Duration 24h

Question 7

BBIT Insulin Therapy

Answer 7

• Basal (intermediate or long acting)
• Bolus at meal time (rapid or short acting)
• Insulin correction (rapid or short acting)
• Tips and protocols (keep glucose 5-10 in hospital, 4-8 at home, follow hypoglycemia protocol if <4)

Question 8

Fixed Combination Insulin Therapy

Answer 8

• Premixed 70/30 insulin
• Fixed ratio of short acting to intermediate acting
• Humulin 30% R 70% N

Question 9

Subcutaneous Insulin Pen

Answer 9

• Personalized ratio for each patient

Question 10

Mixing Insulins

Answer 10

• Inject the proper amount of air into each vial, starting with cloudy
• Draw up clear insulin first
• Draw up Cloudy insulin second

Question 11

SubQ Injection Sites

Answer 11

• Back of arms
• Butt
• Front of thighs
• Stomach (most predictable and rapid absorption)

Question 12

Insulin Interactions

Answer 12

• Insulin antagonists: corticosteroids, diuretics, sympathomimetics, thyroid drugs
• Insulin agonists: Alcohol, sulfa antibiotics, MAOIs, salicylates
• Nonselective beta blockers mask tachycardia from hypoglycemia

Question 13

Long Acting Insulins

Answer 13

• Detemir (Levemir)
• Glargine (Lantus)

Question 14

Intermediate Acting Insulins

Answer 14

• NPH (Humulin-N)

Question 15

Short Acting Insulins

Answer 15

• Regular (Humulin-R)

Question 16

Rapid Acting Insulins

Answer 16

• Aspart (NovoRapid)
• Lispro (Humalog)