Professional Documents
Culture Documents
Med Surg Endocrine PRT 2
Med Surg Endocrine PRT 2
1. Identify and describe the various types of insulin by completing the table below.
Intermediate-Acting: NPH
2. 2.
Match each classification of oral hypoglycemic agents its corresponding mechanism of action.
Term Definition
Sulfonylureas
Meglitinides
Biguanides
Alpha-glucoside inhibitors
Definitions
Reduce glucose production by the liver; enhance the insulin sensitivity; improve glucose transport into the cells
Improve insulin sensitivity, transport, and utilization at target tissues; do not increase insulin production
Increase insulin production from the pancreas; decrease glycogenolysis and gluconeogenesis; enhance cellular sen
Definitions
When taken just before meals, increase pancreatic insulin production during and after the meal, mimicking the norm
Slow down the absorption of carbohydrate in the small intestine; lower postprandial blood glucose
3. 3.
Identify and describe two additional pharmacologic agents useful in treating diabetes mellitus.
2. Questions
1. Exercise 2
2. Online
4. Sign in to work at Pacific View Regional Hospital for Period of Care 1. (Note: If you
are already in the virtual hospital from a previous exercise, click on Leave the Floor and the
on Restart the Program to get to the sign-in window.)
From the Patient List, select Harry George (Room 401).
5. 1.
What medication was ordered to control Harry George's diabetes?
6. 2.
How would you give the IV insulin? (Hint: Consult the Drug Guide in the Nurse's Station.)
7. 3.
At what point after administering Harry George's regular insulin will he be at the greatest risk for
hypoglycemia?
9. 4.
Look at the orders for Monday at 1345. What was the sliding scale insulin order?
11. 5.
According to the Kardex, how often should the capillary blood glucose be tested?
13. 6.
According to the MAR, when should the insulin sliding scale be administered? What was the time of
this order?
14. 7.
What would you do regarding the inconsistencies identified above?
15. 8.
What problems might you anticipate for Harry George if he does not receive insulin coverage at
bedtime?
16. Click on Return to Nurse’s Station and then on 401 at the bottom of the screen.
Click on Clinical Alerts.
17. 9.
Harry George's fasting morning glucose is 206 mg/dL. This manifestation may be explained by:
20. 10.
How much insulin should be administered?
21. 11.
What is the preferred site of administration for fastest absorption?
22. 12.
Fill in the chart below regarding the insulin you just administered.
Expected Length of Time
Onset
Peak
Duration
23. 13.
When performing the assessments on Harry George, which of the following manifestations, if
present, may be indicative of hypoglycemia? Select all that apply.
A.
Diaphoresis
B.
Irritability
C.
Bradycardia
D.
Hunger
E.
Hypertension
F.
Visual disturbances
G.
Weakness
24. 14.
While you are preparing to administer Harry George's insulin, he asks you why he is taking this since
he did not use insulin at home. How would you answer him?
25. 15.
For what side effects related to the current insulin regimen should you monitor Harry George?
3. Questions
1. Exercise 3
2. Online
4. Sign in to work at Pacific View Regional Hospital for Period of Care 4. (Note: If you
are already in the virtual hospital from a previous exercise, click on Leave the Floor and then
on Restart the Program to get to the sign-in window.)
Click on Chart and then on 401. (Remember: You are not able to visit patients or administer
medications during Period of Care 4. You are able to review patients' records only.)
Click on Nurse's Notes.
5. 1.
Glyburide has been prescribed for Harry George. To which of the following classifications does this
medication belong?
A. Alpha-glucosidases
B. Meglitinides
C. Sulfonylureas
D. Biguanides
6. 2.
Read the notes for Wednesday at 1730. What does Harry George request regarding glyburide?
7. 3.
How would you respond to the patient's demands?
8. 4.
How often did Harry George take the glyburide at home?
9. 5.
Why do you think this was increased in the hospital? What concerns might you have regarding this
increase? (Hint: Patient is also receiving insulin.)
10. 6.
For what side effects of glyburide should you assess Harry George? Select all that apply.
A.
Headache
B.
Hypotension
C.
Dizziness
D.
Drowsiness
E.
Peeling skin rash
F.
Itching
G.
Constipation
H.
Feelings of stomach fullness
11. 7.
What specific patient teaching points should you give this patient regarding glyburide?
12. 8.
What additional patient teaching related to diabetes would be appropriate for Harry George?
14. 9.
Below, chart Harry George's blood glucose level and insulin administration since admission to the
medical-surgical unit. (Hint: You may have to review the expired MARs in the chart to verify whether
insulin was given for before the bedtime glucose measurement on Tuesday.)
15. 10.
Based on Harry George's pattern of blood glucose levels, would you evaluate his current therapy as
effective? If not, how might the physician further treat the patient's diabetes?
16. 11.
If you were reviewing the chart on Wednesday evening and found the information recorded in the
table in question 9, what concern would you be ethically and legally bound to report?