Question

ttt-t.tkne.nnt. When the physician talked with JJ's mother, he found out that JJ has a family history of diabetes. His grandfather had diabetes and he has an uncle with diabetes. His mother further explained that JJ had not been as active as usual for the past several days, but he was eating more frequently. She said JJ complained of losing a couple of pounds in two days but she did not believe his weighing was accurate. He was weighing himself daily because he was trying to gain weight to play ball. He is 5'8" and weighs 140 lbs. She did not notice anything else that was unusual. JJ said he had not felt right recently.1 easily and was always hungry. He thought it was because he had been playing so hard. JJ's blood sugar was down the second day after his admission. He was started on 5 units of Humulin R of Humulin N insulin qAM to maintain control. He is to have three meals per day with an AM and hs snack. His energy intake level and snacks for exercise are to be determined by the RD, who is also a CDE. The diabetes teaching nurse is to visit him and instruct him in insulin administration and foot care. insulin and 20 units t te ste ste t k ******ttututttttttttt

Answer 1

6.Lispro is a fast acting insulin. Onset of action is 30 minutes lasting for 5 hours.To be take at the time of food.It is always combined with an intermediate acting insulin like NPH

E.g.,Humlog

NPH (isophane insulin) is an intermediate insulin.Onset of action is 90 minutes lasting for 24 hours.

E.g.,Novolin N

R insulin is a short acting insulin.The onset of action is 30 minutes lasting for 8 hours.It is a form which can be used in combination with all other insulin.It is also used in the treatment of hyperkalemia,gestational diabetes.

E.g.,Actrapid,Humulin

7.Humulin is a short acting neutral insulin,starts acting in 30 minutes and lasting for 8 hours

Porcine is an animal insulin taken from pancreas of pig.It is take from the B cells of Islets of Langerhans.It is a natural insulin with no additives

Bovine insulin is also an animal insulin but taken from the cows.

8.The insulin Humulin R starts acting in 30  minutes ,so it is necessary Yo take food within 30 minutes to prevent hypoglycemia. The effect of Humulin N lasts for 24 hours,so when combined and given every mornin an effective control of blood sugar can be done.

9.Diabetic patients are prone to get Neuropathy (especially in the foot) and may loose sensation. This predisposed them to painless injury if hurt and delayed healing or complications. Hence it is a must to educate on foot care.