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,...
-
Which one of the following is correct? a. Management accounting reports are usually available to the public. b. Management accounting is legislated and governed by regulatory agencies. c. Financial...
-
What are some of the differences between the SI and the customary U.S. system of units? Why is SI preferred for scientific work?
-
\(1,345,321\) Use divisibility rules to determine if each of the following is divisible by 5 .
-
a. Draw a network flow diagram for this problem. b. Create a spreadsheet model for this problem and solve it. c. What is the optimal solution? d. If H&J converted each non-US currency it owns...
-
Logistics Solutions provides order fulfillment services fordot.com merchants. The company maintains warehouses that stockitems carried by its dot.com clients. When a client receives anorder from a 2...
-
Data for Hill Oil Company are as follows for all US properties: Acquisition costs of unproved property, net of impairment.. $ 300,000 400,000 Nondrilling evaluation costs of unproved...
-
Using the fact pattern presented in Exercise 8-15 but assuming that the restructured loan called for a single payment of $60,000 on January 1, 2021, prepare journal entries for CVC and Buffalo Supply...
-
In Exercises 17 and 18, classify the histogram as unimodal or bimodal. Relative Frequency 0.25 0.20 0.15 0.10- 0.05 0 11 12 13 14 15 16 17 18 19 20 21 22 23 24
-
What kind of debt is rescheduled in a Paris Club arrangement? Why is an IMF standby loan agreement required before a Paris Club meeting?
-
Suppose the Federal Reserve Board unexpectedly raises interest rates in the United States. How will this action affect the foreign-exchange market?
-
The following side-by-side bar graph presents the proportions of people residing in various geographic regions of the United States in 1990 and 2015. a. Which regions increased as a proportion of the...
-
What are the major characteristics of offshore financial centers?
-
(a) (10 points) Shares of XYZ stock cost $50 today and will sell for either $125 or $50 next year, with equal probability (1/2,1/2). A one-year zero coupon bond with face value $150 is selling for...
-
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)....
-
The following items create deferred tax assets and deferred tax liabilities at December 31, 2020. 1. Prepaid operating expenses of \(\$ 25,000\) are tax deductible when paid. 2. Excess tax...
-
On January 1, 2020. Keefe Corporation purchased equipment at a cost of \(\$ 100,000\). The equipment has a fiveyear life and no salvage value. The depreciation schedule for tax and accounting...
-
Refer to the data and information given in Problem 18-79 for Keefe Corporation. Assume that the tax rate for 2020 through 2022 is known to be \(25 \%\), but that a new law is passed in 2020 that will...
Study smarter with the SolutionInn App