Kristinelou Marie N.

Reyna January 4, 2020

BSN 2-6 Pharmacology
SAS 21

LESSON PREVIEW
EVERYBODY WRITES

TYPE 1 DM TYPE 2 DM
Insulin dependent diabetes mellitus (IDDM) Non insulin dependent diabetes mellitus
Previous name Juvenile diabetes (NIDDM)
Childhood diabetes
Autoimmune disease Metabolic Condition
Immune system attacks the beta cells in the The pancreas no longer produces enough
Cause pancreas. By destroying these cells, the pancreas insulin or the body is resistant to it. The
can no longer produce insulin pancreas is still functioning just not as well as it
could be.
Insulin Production
Prevention
Age of diagnosis
Risk factors
Treatment
MAIN LESSON
Explain in not less than five sentences the diabetic management triangle.
CHECKING FOR UNDERSTANDING
Multiple Choice

1. C. “Without insulin, you will develop ketoacidosis (DKA).”, D. “The endocrine function of your pancreas is to secrete insulin.”
E. “It means your pancreas cannot secrete insulin.”
Rationale: The endocrine function of the pancreas is to secrete insulin. The endocrine, not the exocrine. Insulin is secreted by the beta
cells. A consequence of diabetes mellitus type 1 is that without insulin, severe metabolic disturbances, such as ketoacidosis
(DKA) will result.

2. B. The nurse should have contacted the physician., C. The nurse should have used regular insulin (Humulin R).
Rationale: Regular insulin is the only insulin that can be given intravenously (IV). The nurse did not use correct insulin as it was not
regular insulin. Contact the provider to clarify the order, regular insulin is the only insulin that can be given intravenously
(IV).

3. D. The client will have moist skin.

Rationale: Moist skin is the sign of hypoglycemia, which the client would experience if he injected himself with insulin and did not
eat.

4. C. The 42-year-old client who is 50 pounds overweight

Rationale: Obesity increases the likelihood of developing diabetes mellitus due to the overstimulation of the endocrine system.

5. A. Potassium
Rationale: Insulin causes potassium to move into the cell and may cause hypokalemia. There is no need to monitor the sodium. serum
amylase. and AST levels.

6. B. It must be taken with meals., C. It decreases sugar production in the liver., E. It reduces insulin resistance.
Rationale: Metformin (Glucophage) reduces insulin resistance, decreases sugar production in the liver, and should be taken with meals
for the best absorption and effect.

7. D. “I should only use calibrated insulin syringe for the injections.”

Rationale: This is to ensure the correct insulin dose, a calibrated insulin syringe must be used.

8. C. The alcohol could predispose you to hypoglycemia.

Rationale: Alcohol can potentiate hypoglycemic effects in the client. Alcohol can cause pancreatic disease but the client’s pancreas is
not producing any insulin currently.

9. A. When the client is eating

Rationale: The onset action for the insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating to prevent
hypoglycemia.

10. C. Have the client place the insulin vials in the refrigerator.
Rationale: Vials not in use should be refrigerated to preserve drug potency.

11. D. Lantus insulin 20U BID.

Rationale: Lantus insulin is usually prescribed once-a-day so an order for BID dosing should be validated with the physician.

12. D. Perineal itching

Rationale: Older women might complain of perineal itching due to vaginal candidiasis.

13. A. Miglitol
Rationale: The enzyme that breaks down glucose for absorption is called alpha glucosidase. Drugs under alpha glucosidase inhibitors
include acarbose and miglitol.

14. C. Thiazolidinediones
Rationale: Thiazolidinediones pioglitazone and rosiglitazone work by decreasing insulin resistance.

15. C. Human amylin

Rationale: Signs of toxicity include hypokalemia, weight gain, edema, and hypertension. Muscle weakness and abdominal fullness can
be signs and symptoms of hypokalemia.

LESSON WRAP-UP
DAILY DOZEN