delivery system – 投药系统
Insulin Jet Injector -- 胰岛素喷枪注射器
cylindrical – a. 圆筒状的
shoot – v. 发射
dispose (of) – v. 处理，配置
Insulin Pen – 胰岛素笔
barrel – n. 圆桶，枪管
reinforcement – n. 强化，强固
Insulin Pump – 胰岛素泵
awkward – a. 笨拙的，尴尬的
long-acting insulin – 长效胰岛素
inhaled insulin – 吸入性胰岛素
Exubera – n. 【奥】艾索贝拉
monotherapy – n. 单药疗法
Afreeza – n. 【奥】阿福礼扎
spirometry – n. 肺量测定
rapid-acting insulin –速效胰岛素
Humulin R – 优泌林R
Insulin glargine – 甘精胰岛素
Insulin lispro -- 赖脯胰岛素 注：带“【奥】”标记者为奥医临时用名，只为方便学员复习记忆，不得作为临床诊疗依据！
“RN-ISPN考试复习要点提示”
帮助您尽快理清复习思路，准确抓住复习重点，是ISPN/RN考试复习的一大利器！
★RN/ISPN Review ★
Insulin Delivery 胰岛素使用
Subcutaneous Insulin Injection: This remains the primary delivery system. 皮下注射胰岛素：维持了初期的使用系统
Insulin Jet Injector: This cylindrical device shoots a fine spray of insulin through the skin under very high pressure. Although it is appealing for people who do not like needles or have problems disposing of needles properly, it can be very expensive. 胰岛素喷枪注射器：该圆柱型装置采用高压将精微的胰岛素喷雾注入皮肤。虽然这一方式受到不喜欢针头或针头正确处理有困难的患者的喜欢，但可能价格太贵。
Insulin Pen: This syringe-like device looks like a pen. It has a small needle at the tip and a barrel that holds insulin. The patient “dials” the amount of insulin to be given and injects the insulin subcutaneously by pressing on the top of the pen. This is advantageous for people who need insulin two or three times during the day but cannot easily transport syringes and needles. It is a subtle way to give insulin and is popular with students and business people on the go. It is important to rotate the syringe 15 to 20 times before injecting the insulin to disperse it. Patients often forget this point after using the pens for a while, and as a result may inject far too much or too little insulin when it is needed. Periodic reinforcement of the administration instructions is important.
External Insulin Pump: This pump device can be worn on a belt or hidden in a pocket and is attached to a small tube inserted into the subcutaneous tissue of the abdomen. The device slowly leaks a base rate of insulin into the abdomen all day; the patient can pump or inject booster doses throughout the day to correspond with meals and activity. The device does have several disadvantages. For example, it is awkward, the tubing poses an increased risk of infection and requires frequent changing, and the patient has to frequently check blood glucose levels throughout the day to monitor response.
IV Insulin: In emergency situations or when rapid and continual control of blood glucose is needed, insulin can be given IV. Insulin is considered a high-risk drug when given this way. There is potential for rapid changes in blood glucose and resultant risk to the CNS and heart. IV insulin should be given using a controlled delivery pump and the patient should be constantly monitored and frequent blood glucose levels should be done to adjust the dosage appropriately.
Long-Acting Insulin: The year 2001 brought the release of a subcutaneous insulin that lasts two to three times longer than NPH insulin. This should decrease the need for multiple injections and may increase glucose control, especially for patients with erratic glucose levels during the night. The long-term effects of this type of insulin therapy are not yet known.
Inhaled Insulin: The lung tissue is one of the best sites for insulin absorption. An aerosol delivery system has been developed that delivers a powdered insulin formulation directly into the lung tissue. In early 2006 the FDA approved Exubera for the treatment of adult patients with diabetes mellitus for the control of hyperglycemia. In patients with type 1 diabetes, it was designed to be used in combination with longer acting insulins; patients with type 2 diabetes could use it as monotherapy or in combination with other antidiabetic agents. In 2007, however, Exubera was withdrawn from the market with disappointing sales. Although pulmonary function was shown to decline while using this form of insulin, this was not cited as a cause for the withdrawal; phase III studies showed an increase in insulin antibody formation in patients using inhaled insulin in clinical trials, sending the drug back for further refinement and research. Inhaled insulin was released again in 2014 as Afreeza. There are warnings that problems could occur with people who have asthma, COPD, or lung cancer and a baseline and periodic spirometry is suggested. It is a rapid-acting insulin that is inhaled at the beginning of a meal. If used in type 1 diabetes, it must be combined with a long-acting insulin. The most common adverse effects are cough, throat irritation, and hypoglycemia. Because of adverse effects seen in clinical studies it is suggested that patients using this form of insulin may experience more ketoacidosis, hypokalemia, and life-threatening hypoglycemia than patients receiving insulin by injection. Careful monitoring and patient teaching is important.
1. A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to:
A. Administer regular insulin intravenously
B. Administer 5% dextrose intravenously
C. Correct the acidosis
D. Apply an electrocardiogram monitor.
2. When a client is in diabetic ketoacidosis, the insulin that would be administered is:
A. Human NPH insulin
B. Human regular insulin
C. Insulin lispro injection
D. Insulin glargine injection
奥医教育“在线自测”题库
ISPN/RN复习练习、效果检验一站完成。
答案 Answers 1. A. Administer regular insulin intravenously Rationale: Lack (absolute or relative) of insulin is the primary cause of DK1. Treatment consists of insulin administration (regular insulin), IV fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis. Applying an electrocardiogram monitor is not a priority action. 2. B. Human regular insulin Rationale: Regular insulin (Humulin R) is a short-acting insulin and is administered via IV with an initial dose of 0.3 units/kg, followed by 0.2 units/kg 1 hour later, followed by 0.2 units/kg every 2 hours until blood glucose becomes <13.9 mmol/L (<250 mg/dL). At this point, insulin dose should be decreased by half, to 0.1 units/kg every 2 hours, until the resolution of DKA.
当前位置：
