Less 2 Hrs After Meal: Goals For Blood Glucose Levels During Pregnany: 95 MG/DL or Less Before Meals and 120 MG/DL or

Goals for blood glucose levels during pregnany: 95 mg/dL or less before meals and 120 mg/dL or
less 2 hrs after meal
Normal Fasting plasma glucose value: less than 126mg/dL
Two-hour postload glucose less than 200 mg/dL
ROC- room of choice
UDS- urine dip stick
SUA- serum uric acid
RI SC- regular insulin sliding scale
RBS- random blood sugar
A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal.
more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes
between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes
Scale:
<60mg/dl 1 amp D50 IV stat then call AP
130-160 mg/dl 2 units
160-200 mg/dl 4 units
201-250mg/dl 6 units
Above 351mg/dl 12 units then call AP ASAP
ABG normal value:
Normal Na+- 135-145mEq/L
Normal K+- 3.5-5mEq/L
Normal Cl+- 98-106mEq/L
Solution:
mL/ hour= total volume/ hours to run= 90ml/hr
Ml/min= mL/hr/60mins= 1.5ml/min
Gtts/min= Ml/hr x drop factor % 60mins
900/10 x 20/60=30gtts/min
Humulin R
Classification: antidiabetic Short-acting insulin: This type takes about 30 to 60

minutes to become active in your bloodstream. It peaks in two to four hours,
and its effects can last for five to eight hours. It is sometimes called regular-
acting insulin.
Onset: ½-1h; Peak: 2-3h; Duration: 4-6h

Indication: control high blood sugar level in patient with type 2 DM
action: lowers blood glucose by stimulating peripheral glucose uptake by binding to

insulin receptors on the skeletal muscle and in fat cells and inhibiting hepatic glucose
production.
side effects: allergic reaction, peripheral edema
adverse effects: anaphylaxis, hypoglycemia
contraindication: episodes of hypoglycemia, hypersensitivity to drugs
intervention: don’t use if solution is cloudy or viscous
monitor closely the glucose level and serum potassium level
instruct to eat within 30 minutes of injecting short acting insulin.
Omeprazole (Prisolec) (proton pump inhibitor)
Treament for GERD
Action: blocks hydrogen potassium adenosine triphosphate, an enzyme on the

surface of gastric parietal cells, in order to inhibit gastric acid secretion.
Omeprazole works by decreasing the amount of acid your stomach makes and this
is taken before meals to control of daytime gastric acidity. The parietal cell is
maximally stimulated as it is after a meal which secretes gastric acid.
Blocks hydrogen ion which is responsible for HCL production
Contraindication: hypersensitivity to omeprazole
Side effects: headache, nausea/ vomiting, abdominal pain, dizziness, abdominal

cramping
Nursing management:
 Provide non-pharmacological management positioning to most comfortable one, deep
breathing exercise, and calm environment, hot compress
 Provide diversional activities watching TV or listening to music
 Instruct pt. to avoid any food or drinks like alcohol that can cause increase GI irritation
 Instruct to take before meals
 Check patency of Iv site
Gastrointestinal losses of potassium usually are due to prolonged diarrhea

or vomiting,
Hypokalemia is present when serum levels of potassium are lower than
Metoclopramide (plasil) anti-emetic
Action: block dopamine and serotonin receptor. Metoclopramide is a dopamine 2

receptor antagonist which blocks the receptor on the chemoreceptor trigger zone in the
brain stem and it stops to signal the vomiting center in the medulla that cause
prevention of vomit. It also block the serotonin receptor located in the solitary tract
nucleus also in the brain stem that also stops to signal the vomiting center in the
medulla.
Indication: Prevent N/V
Side effects: dizziness, diarrhea, feeling drowsy of sleepy
Intervention: raise side rails to prevent fall, encourage taking low fiber food like
banana, do not drink alcohol beverage, avoid activities that requires alertness, check iv
patency
Contraindication: hypersensitive to metoclopramide
Lantus (Glargine)
Recombinant human insulin analog that control high blood sugar
Classification: antidiabetic Long-acting insulin: This type takes the longest

amount of time to start working. The insulin can take up to 4 hours to get into
your bloodstream.
Onset: 6-8h; peak: 12-16h; duration: 20-30h

Action: lowers blood glucose by stimulating peripheral glucose uptake by binding to
insulin receptors on the skeletal muscle and in fat cells and inhibiting hepatic glucose
production.
Side effects: abdominal pain, headache, N/V,
Adverse effects: hypoglycemia, lipodystrophy kay naga pa shrink ng fats or subq
Contraindication: hypersensitive to drug, during episodes of hypoglycemia,
Intervention: monitor glucose level, monitor injecting site
Wash hands clean injection site, remove air,
Why it is given HS: It reduces fasting blood glucose levels more efficiently and with less
nocturnal hypoglycemic events compared with human neutral protamine Hagedorn
(NPH) insulin.
 non-pharmacologic management
 monitor Hba1c (glycosylated hgb/ less than 6.5% or less than 48mmol/mol) level
 monitor s/s of hypoglycemia like shaking, confusion, sweating
 monitor for hyperglycemia like frequent urination, thirsty, drowsiness
Metformin (Fortamet, Glucophage)
Classification: antidiabetic agent
Indication: is the first-line medication for the treatment of type 2 diabetes,
Action: activate the enzyme adenosine monophosphate activated protein kinase in the
liver which inhibits the gluconeogenesis that can lead to decrease glucose production
works by reducing the amount of sugar your liver releases into your blood.
Side effects: GI upset, N/V, diarrhea, abdominal bloating, anorexia
decrease intestinal glucose absorption as it delays gastric emptying and reduces

appetite can cause weight loss.
Adverse effects: lactic acidosis, hypoglycemia
to inhibition of gluconeogenesis by blocking pyruvate carboxylase, the first step of

gluconeogenesis responsible in converting pyruvate to oxaloacetate. Blocking this enzyme
leads to accumulation of lactic acid. Lactic acid is produced when oxygen levels, become low
in cells within the areas of the body where metabolism takes place.
Contraindication: hypersensitive to metformin, sever renal disease, malnourished

patient.
Intervention: give with meals, don’t crush or cut extended-release drugs
Monitor pt’s glucose level regularly to evaluate effectiveness of therapy.
Monitor V/S especially BP
Gliclazide (Diamicron)
Classification: is a sulfonylurea type of anti-diabetic medication
Only effective in patients who have functioning beta cells not for type 1.
Indication: used to treat diabetes mellitus type 2.
Action: increased beta cell in the production of insulin
Side effects: GI upset, N/V, constipation
Adverse effects: hypoglycemia
Contraindication: type 1 these patients don’t have functioning beta cells and would
have no benefit from this. Allergy to this drug
Intervention: monitor glucose level, monitor nutritional status, provide comfort

measure, monitor V/S
Infection causes a stress response in the body by increasing the amount of certain hormones such as
cortisol and adrenaline. These hormones work against the action of insulin and, as a result, the body's
production of glucose increases
oo ga taas bp kay ang blood viscous which is mag compensate ang heart mag increase ang work ka
heart para mag produce enough oxygen sa body mag taas pressure
Insulin is the hormone produced by the pancreatic beta cells of the islets of Langerhans. It
is released into circulation when the levels of glucose around the cells arise. Insulin
circulates through the body and reacts with specific insulin receptor sites to stimulate the
transport of glucose into cells to be used for energy (facilitated diffusion).
 Diabetes is classified into two: type 1 and type 2. Type 1 diabetes is

common in younger people and is connected with cases of viral
destruction of beta cells of the pancreas. On the other hand, type 2 is
adult-onset and is associated with not enough insulin to maintain glucose
control.
Diabetic diet
Brown rice
Oatmeal
Brown bread
High fiber diet
Less carbs
Type 1- Insulin dependent insulin management
Type 2- Insulin resistant nutritional diet and exercise

Hormones produced during pregnancy: Cortisol, estrogen, human placental lactogen
Osmotic diuresis- kung magihi may glucose te ang glucose diba kay solute kung diin may solute didto
man ang water amo na damo ihi nya te kung damo ihi nya may loss of water and electrolytes which could
lead to dehydration
3Ps
Polydipsia- increase thirst
Polyphagia- increase eating
Polyuria- increase urination
increased thirst thus more oral intake leads to polyuria tapos amo na istimulate sang aton brain na amo
na mag inom ka tubig na damo gina uhaw ka nan

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Less 2 Hrs After Meal: Goals For Blood Glucose Levels During Pregnany: 95 MG/DL or Less Before Meals and 120 MG/DL or

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Goals for blood glucose levels during pregnany: 95 mg/dL or less before meals and 120 mg/dL or

less 2 hrs after meal

Normal Fasting plasma glucose value: less than 126mg/dL

Two-hour postload glucose less than 200 mg/dL

ROC- room of choice

UDS- urine dip stick

SUA- serum uric acid

RI SC- regular insulin sliding scale

RBS- random blood sugar

<60mg/dl 1 amp D50 IV stat then call AP

130-160 mg/dl 2 units

160-200 mg/dl 4 units

Above 351mg/dl 12 units then call AP ASAP

ABG normal value:

Normal Na+- 135-145mEq/L

Normal K+- 3.5-5mEq/L

Normal Cl+- 98-106mEq/L

mL/ hour= total volume/ hours to run= 90ml/hr

Ml/min= mL/hr/60mins= 1.5ml/min

Gtts/min= Ml/hr x drop factor % 60mins

Classification: antidiabetic Short-acting insulin: This type takes about 30 to 60

Onset: ½-1h; Peak: 2-3h; Duration: 4-6h

action: lowers blood glucose by stimulating peripheral glucose uptake by binding to

side effects: allergic reaction, peripheral edema

adverse effects: anaphylaxis, hypoglycemia

contraindication: episodes of hypoglycemia, hypersensitivity to drugs

intervention: don’t use if solution is cloudy or viscous

monitor closely the glucose level and serum potassium level

instruct to eat within 30 minutes of injecting short acting insulin.

Omeprazole (Prisolec) (proton pump inhibitor)

Treament for GERD

Action: blocks hydrogen potassium adenosine triphosphate, an enzyme on the

Contraindication: hypersensitivity to omeprazole

Side effects: headache, nausea/ vomiting, abdominal pain, dizziness, abdominal

 Provide diversional activities watching TV or listening to music

 Instruct to take before meals

 Check patency of Iv site

Gastrointestinal losses of potassium usually are due to prolonged diarrhea

Hypokalemia is present when serum levels of potassium are lower than

Metoclopramide (plasil) anti-emetic

Action: block dopamine and serotonin receptor. Metoclopramide is a dopamine 2

Indication: Prevent N/V

Side effects: dizziness, diarrhea, feeling drowsy of sleepy

Contraindication: hypersensitive to metoclopramide

Recombinant human insulin analog that control high blood sugar

Classification: antidiabetic Long-acting insulin: This type takes the longest

Onset: 6-8h; peak: 12-16h; duration: 20-30h

Adverse effects: hypoglycemia, lipodystrophy kay naga pa shrink ng fats or subq

Contraindication: hypersensitive to drug, during episodes of hypoglycemia,

Intervention: monitor glucose level, monitor injecting site

Wash hands clean injection site, remove air,

Metformin (Fortamet, Glucophage)

Classification: antidiabetic agent

Indication: is the first-line medication for the treatment of type 2 diabetes,

Side effects: GI upset, N/V, diarrhea, abdominal bloating, anorexia

decrease intestinal glucose absorption as it delays gastric emptying and reduces

Adverse effects: lactic acidosis, hypoglycemia

to inhibition of gluconeogenesis by blocking pyruvate carboxylase, the first step of

Contraindication: hypersensitive to metformin, sever renal disease, malnourished

Intervention: give with meals, don’t crush or cut extended-release drugs

Monitor pt’s glucose level regularly to evaluate effectiveness of therapy.

Monitor V/S especially BP