The purpose of this exercise is to examine the consequences of less acute insulin deficiency on...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
The purpose of this exercise is to examine the consequences of less acute insulin deficiency on blood glucose. Left untreated this condition results in hyperosmolar. hyperglycemic nonketotic coma (HHNK) and death. Ms HG, an 80 year old female patient was admitted to the ICU from a nursing home. She has a history of type 2 diabetes mellitus of 10 years duration and is normally controlled with Avandia (a hypoglycemic agent) and glucophage. She had a Foley catheter (urinary) in place. On admission she was febrile (101 F),delirious, and uroseptic. Her admitting blood glucose was 840 mg/dL.. And she displayed S&S of severe dehydration. A diagnosis of HHNK was quickly made. Upon admission at 8AM she was given an antibiotic and started on an insulin drip. Regular insulin in ½ saline was administered IV. Blood glucose was determined hourly. In response to the insulin drip blood glucose levels declined throughout the day as illustrated by the data below. At 5 PM the patient appeared gray and clammy and the nurse suspected a hypoglycemic reaction. This suspicion was confirmed by a blood glucose level of 52. The patient was given ½ ampule of D50 (a sugary supplement) thereby rapidly increasing the blood glucose to 100 mg/dL. In determining the cause of the hypoglycemia, the nurse noted a failure to change the IV from ½ saline to a dextrose (sugary) solution at 3PM as the blood glucose was approaching normal. Time 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00 6:00 7:00 8:00 Blood Glucose (mg/dL) 840 750 700 610 450 350 220 200 120 90 52 100 110 Questions a Construct a graph. Using the coordinates of blood glucose/time, plot the blood glucose data in the space above b. Indicate on the graph the time that the insulin drip was begun. What happens to blood glucose in response to the insulin drip? e. Indicate on the graph the time that the patient became hypoglycemic d. Indicate on the graph the time at which the ½ ampule D50 was administered. e. The normal blood glucose is 70-110 mg/dL. At what times was she hyperglycemic? What caused the glucose to decline? f At what time was she hypoglycemic? What caused the hypoglycemia? 2. Graphic Description of Insulin Time Courses a. Note the time course of Rapid-acting insulin (Lispro). (Lewis/Mosby) h 6 AM Noon Rapid-acting... Onset: 15 min Peak: 60-90 min Duration: 3-4 hrs Short-acting... Onset: 30-60 min Peak: 2-3 hrs Duration: 4-6 hrs Intermediated-acting... Onset: 2 hrs Peak: 6-8 hrs Duration: 12-16 hrs Long-acting... On the graph above, draw in the time courses of the following 4 types of insulin (regular, NPH, ultralente, glargine). Onset: 2 hrs Peak: 16-20 hrs Duration: 24+ hrs Action Long-acting 6 PM Lispro Regular insulin NPH Ultralente Glargine Midnight Onset: 1-2 hrs Peak: no pronounced peak Duration: 24+ hrs hrs 6 AM The purpose of this exercise is to examine the consequences of less acute insulin deficiency on blood glucose. Left untreated this condition results in hyperosmolar. hyperglycemic nonketotic coma (HHNK) and death. Ms HG, an 80 year old female patient was admitted to the ICU from a nursing home. She has a history of type 2 diabetes mellitus of 10 years duration and is normally controlled with Avandia (a hypoglycemic agent) and glucophage. She had a Foley catheter (urinary) in place. On admission she was febrile (101 F),delirious, and uroseptic. Her admitting blood glucose was 840 mg/dL.. And she displayed S&S of severe dehydration. A diagnosis of HHNK was quickly made. Upon admission at 8AM she was given an antibiotic and started on an insulin drip. Regular insulin in ½ saline was administered IV. Blood glucose was determined hourly. In response to the insulin drip blood glucose levels declined throughout the day as illustrated by the data below. At 5 PM the patient appeared gray and clammy and the nurse suspected a hypoglycemic reaction. This suspicion was confirmed by a blood glucose level of 52. The patient was given ½ ampule of D50 (a sugary supplement) thereby rapidly increasing the blood glucose to 100 mg/dL. In determining the cause of the hypoglycemia, the nurse noted a failure to change the IV from ½ saline to a dextrose (sugary) solution at 3PM as the blood glucose was approaching normal. Time 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00 6:00 7:00 8:00 Blood Glucose (mg/dL) 840 750 700 610 450 350 220 200 120 90 52 100 110 Questions a Construct a graph. Using the coordinates of blood glucose/time, plot the blood glucose data in the space above b. Indicate on the graph the time that the insulin drip was begun. What happens to blood glucose in response to the insulin drip? e. Indicate on the graph the time that the patient became hypoglycemic d. Indicate on the graph the time at which the ½ ampule D50 was administered. e. The normal blood glucose is 70-110 mg/dL. At what times was she hyperglycemic? What caused the glucose to decline? f At what time was she hypoglycemic? What caused the hypoglycemia? 2. Graphic Description of Insulin Time Courses a. Note the time course of Rapid-acting insulin (Lispro). (Lewis/Mosby) h 6 AM Noon Rapid-acting... Onset: 15 min Peak: 60-90 min Duration: 3-4 hrs Short-acting... Onset: 30-60 min Peak: 2-3 hrs Duration: 4-6 hrs Intermediated-acting... Onset: 2 hrs Peak: 6-8 hrs Duration: 12-16 hrs Long-acting... On the graph above, draw in the time courses of the following 4 types of insulin (regular, NPH, ultralente, glargine). Onset: 2 hrs Peak: 16-20 hrs Duration: 24+ hrs Action Long-acting 6 PM Lispro Regular insulin NPH Ultralente Glargine Midnight Onset: 1-2 hrs Peak: no pronounced peak Duration: 24+ hrs hrs 6 AM
Expert Answer:
Answer rating: 100% (QA)
A C B b The glucose level starts to drop as soon as the insul... View the full answer
Related Book For
Introductory Econometrics A Modern Approach
ISBN: 978-0324660548
4th edition
Authors: Jeffrey M. Wooldridge
Posted Date:
Students also viewed these accounting questions
-
The purpose of this exercise is to provide practice using LINGO or Excel Solver. Find the values of X and Y that minimize the function Min X2 - 4X + Y2 + 8Y + 20 Do not assume non-negativity of the X...
-
The purpose of this exercise is to get you familiar with strategy terms introduced and defined in this chapter. Let's apply these terms to Pepsico, Inc. (stock symbol = PEP). Instructions: Step 1: Go...
-
The purpose of this exercise is to demonstrate that it is much more beneficial to begin to invest for retirement early than it is to wait. We will compare the investments of two investors, Alberto...
-
If the molecular weight of air is 28.9, what is the density of air at atmospheric pressure and a temperature of 328.2 K? 1 atm = 1.013 x 10 5 N/m, the mass of a proton is 1.67262 x 10 -27 kg,...
-
Parker Inc. has the following cash balances: First Bank ....... $ 150,000 Second Bank ...... (10,000) Third Bank ....... 25,000 Fourth Bank ........ (5,000) Required: 1. Prepare the current assets...
-
Complete each statement. The commutative property is used to change the _______ of two terms or factors.
-
Imagine putting a single and a double brick on a flat board, as in Figure 10.40, and then slowly raising one end of the board. (a) Does the single brick begin to slide before, after, or at the same...
-
Castro Company makes and sells a single product. Castro incurred the following costs in its most recent fiscal year. Cost Items Appearing on the Income Statement Materials cost ($9 per unit)...
-
You are given an undirected graph consisting of n vertices and m edges. It is guaranteed that the given graph is connected (i. e. it is possible to reach any vertex from any other vertex) and there...
-
Moravanti Italian Imports has four employees and pays biweekly. Assume that box 2 is not checked for L. Torabi and R. Beninati and is checked for G. Fisher and J. Tillman. Required: Complete the W-4...
-
Analyze the strategy in each of the periods you identified by determining if the changes led to a better or worse strategic position for Starbucks. In other words, given the changes in the various...
-
James has been working closely with a new supplier in India to produce products for the U.S. market. James has offered several suggestions to improve the efficiency of the assembly line, but every...
-
You are Assistant Manager of Royal Bank of Canada. Your bank recently changed policy in regard to dressing in the bank. With effect from April 1, 2021 only formal clothing is allowed from Monday to...
-
SYDNEY Account Help board ProctorU Help centre SONY is considering to set up a plant in the city of Shenchen to produce its Smart LED TV in China You are given the following facts about the...
-
Akiak Nori was raised in Arviat, Nunavut, and then attended a career school in Thunder Bay, Ontario, majoring in electronic technology. Approaching graduation, he sorted through dozens of job offers...
-
1) Microsoft Outlook 2) Microsoft Teams 3) Whatsapp/Phone massager 4) Google Gmail 5) Google Meet 6) Google Chat and many more with above mentioned, how employees use digital communication to...
-
This question is finance-related and taken from the 2015 film The Big Short: The movie begins with this quote: It ain't what you don't know that gets you into trouble. It's what you know for sure...
-
a. Why does the Wi-Fi Alliance release compatibility testing profiles in waves instead of combining the entire standards features initially? 27a1.) An 802.11ac Wi-Fi compatibility testing profile...
-
Use the data in RENTAL.RAW for this exercise. The data on rental prices and other variables for college towns are for the years 1980 and 1990. The idea is to see whether a stronger presence of...
-
Confirm the partialling out interpretation of the OLS estimates by explicitly doing the partialling out for Example 3.2. This first requires regressing educ on exper and tenure and saving the...
-
Use the data in BARIUM.RAW for this exercise. (i) Estimate the linear trend model chnimp, = a + fit + ur using the first 119 observations (this excludes the last 12 months of observations for 1988)....
-
Two radio stations have the same power output from their antennas. One broadcasts AM at a frequency of \(1000 \mathrm{kHz}\) and one broadcasts FM at a frequency of \(100 \mathrm{MHz}\). Which...
-
A paramecium is covered with motile hairs called cilia that propel it at a speed of \(1 \mathrm{~mm} / \mathrm{s}\). If the paramecium has a volume of \(2 \times 10^{-13} \mathrm{~m}^{3}\) and a...
-
How many photons does a \(5.0 \mathrm{~mW}\) helium-neon laser \((\lambda=633 \mathrm{~nm})\) emit in 1 second? A. \(1.2 \times 10^{19}\) B. \(4.0 \times 10^{18}\) C. \(8.0 \times 10^{16}\) D. \(1.6...
Study smarter with the SolutionInn App