Editing Pharmacology – LPN Flashcards (section)

== Endocrine ==

;Which insulin is cloudy, and what is the mixing rule?
:NPH is the only routinely cloudy insulin. When mixing regular with NPH, draw up clear before cloudy after injecting air into both vials. Long-acting insulins such as glargine and detemir are never mixed with other insulins.

;Treatment of hypoglycemia in a conscious client?
:The 15-15 rule: give 15 grams of fast-acting carbohydrate such as 4 ounces of juice or regular soda, 3 to 4 glucose tablets, or a tablespoon of honey, then recheck the glucose in 15 minutes and repeat if still low. Follow with a protein-containing snack if the next meal is not soon, and report the episode. Signs to recognize: shakiness, sweating, rapid heartbeat, hunger, headache, irritability, blurred vision, and confusion. Never give anything by mouth to a client who is not fully awake and able to swallow.

;How is levothyroxine taken?
:In the morning on an empty stomach with a full glass of water, at least 30 to 60 minutes before food, and separated from calcium, iron, and antacids by about 4 hours. Report palpitations, weight loss, heat intolerance, or insomnia, which suggest too high a dose. Therapy is usually lifelong.

;Key teaching for a client on prednisone?
:Take with food, never stop abruptly because the dose must be tapered, monitor blood glucose, report signs of infection since fever may be blunted, weigh regularly because of fluid retention, and expect mood changes and increased appetite.