[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.34,0:00:02.49,Default,,0000,0000,0000,,(bright music)
Dialogue: 0,0:00:02.49,0:00:04.23,Default,,0000,0000,0000,,- Now as far as diabetic treatments, guys
Dialogue: 0,0:00:04.23,0:00:06.27,Default,,0000,0000,0000,,we're gonna cover all\Nthe diabetic pharmacology
Dialogue: 0,0:00:06.27,0:00:08.04,Default,,0000,0000,0000,,including the seven rules of insulin.
Dialogue: 0,0:00:08.04,0:00:08.94,Default,,0000,0000,0000,,So write these down.
Dialogue: 0,0:00:08.94,0:00:10.65,Default,,0000,0000,0000,,These are the most tested.
Dialogue: 0,0:00:10.65,0:00:12.00,Default,,0000,0000,0000,,So remember, Type One
Dialogue: 0,0:00:12.00,0:00:14.43,Default,,0000,0000,0000,,we have none or no insulin.
Dialogue: 0,0:00:14.43,0:00:16.02,Default,,0000,0000,0000,,The body destroyed the pancreas
Dialogue: 0,0:00:16.02,0:00:18.66,Default,,0000,0000,0000,,so they are insulin dependent for life.
Dialogue: 0,0:00:18.66,0:00:21.78,Default,,0000,0000,0000,,And Type Two, the\Nproblem is you, your diet
Dialogue: 0,0:00:21.78,0:00:23.31,Default,,0000,0000,0000,,and a little bit of genetics.
Dialogue: 0,0:00:23.31,0:00:27.12,Default,,0000,0000,0000,,So remember Type Two, we have\Nfew insulin receptors working.
Dialogue: 0,0:00:27.12,0:00:30.81,Default,,0000,0000,0000,,So the first treatment is\Nto fix you, your habits.
Dialogue: 0,0:00:30.81,0:00:31.92,Default,,0000,0000,0000,,So we focus on diet
Dialogue: 0,0:00:31.92,0:00:35.22,Default,,0000,0000,0000,,and exercise to help repair\Nthose broken receptors
Dialogue: 0,0:00:35.22,0:00:38.37,Default,,0000,0000,0000,,aka increase insulin sensitivity.
Dialogue: 0,0:00:38.37,0:00:41.01,Default,,0000,0000,0000,,Then we give drugs like\Noral meds and insulin
Dialogue: 0,0:00:41.01,0:00:44.58,Default,,0000,0000,0000,,but only if diet and exercise,\Ndon't manage it alone.
Dialogue: 0,0:00:44.58,0:00:48.36,Default,,0000,0000,0000,,So for our seven insulin\Nrules, peaks equals plate guys.
Dialogue: 0,0:00:48.36,0:00:52.23,Default,,0000,0000,0000,,Typically we give food during\Na peak since the greatest risk
Dialogue: 0,0:00:52.23,0:00:55.11,Default,,0000,0000,0000,,for low sugar is during\Nthose insulin peaks.
Dialogue: 0,0:00:55.11,0:00:57.45,Default,,0000,0000,0000,,Guys, the number one\Nway to kill your patient
Dialogue: 0,0:00:57.45,0:00:59.79,Default,,0000,0000,0000,,is not giving food during the peaks.
Dialogue: 0,0:00:59.79,0:01:02.01,Default,,0000,0000,0000,,So know your peak times.
Dialogue: 0,0:01:02.01,0:01:06.56,Default,,0000,0000,0000,,During peaks we monitor for\Nthat low sugar, sugar below 70.
Dialogue: 0,0:01:06.56,0:01:10.44,Default,,0000,0000,0000,,Now number two, if you\Nget low sugar below 70
Dialogue: 0,0:01:10.44,0:01:11.91,Default,,0000,0000,0000,,or if your patient looks shaky
Dialogue: 0,0:01:11.91,0:01:15.54,Default,,0000,0000,0000,,or trembly, the classic\Nsigns pale, cool, sweaty
Dialogue: 0,0:01:15.54,0:01:19.62,Default,,0000,0000,0000,,or even clammy, give that\Npatient some sugary candy.
Dialogue: 0,0:01:19.62,0:01:22.95,Default,,0000,0000,0000,,The priority key terms again,\Nare the A's and the S's.
Dialogue: 0,0:01:22.95,0:01:24.27,Default,,0000,0000,0000,,If your patient is awake
Dialogue: 0,0:01:24.27,0:01:27.39,Default,,0000,0000,0000,,ask them to eat, always\Nsugary food here guys.
Dialogue: 0,0:01:27.39,0:01:30.93,Default,,0000,0000,0000,,So soda, juices, crackers,\Nand low fat milk.
Dialogue: 0,0:01:30.93,0:01:33.06,Default,,0000,0000,0000,,Not high fat milk or peanut butter.
Dialogue: 0,0:01:33.06,0:01:35.70,Default,,0000,0000,0000,,Guys, fat will slow the\Nsugar absorption here.
Dialogue: 0,0:01:35.70,0:01:39.18,Default,,0000,0000,0000,,And if they're sleeping, then\Nwe stab them with IV D50.
Dialogue: 0,0:01:39.18,0:01:42.21,Default,,0000,0000,0000,,Sleeping means unresponsive\Nor unarousable,
Dialogue: 0,0:01:42.21,0:01:44.69,Default,,0000,0000,0000,,responsive only two painful stimuli.
Dialogue: 0,0:01:44.69,0:01:48.15,Default,,0000,0000,0000,,So don't just go stabbing\Nsleeping diabetics here, guys
Dialogue: 0,0:01:48.15,0:01:51.69,Default,,0000,0000,0000,,always assess the sugar\Nand symptoms first.
Dialogue: 0,0:01:51.69,0:01:54.99,Default,,0000,0000,0000,,And after you give sugar, always\Nreassess 15 minutes later,
Dialogue: 0,0:01:54.99,0:01:57.84,Default,,0000,0000,0000,,we always follow up after any intervention
Dialogue: 0,0:01:57.84,0:02:00.42,Default,,0000,0000,0000,,always checking the\Nsugar and the symptoms.
Dialogue: 0,0:02:00.42,0:02:04.38,Default,,0000,0000,0000,,Now the third rule, insulin\Nwith no peaks and no mixes.
Dialogue: 0,0:02:04.38,0:02:06.33,Default,,0000,0000,0000,,It's our long acting dudes.
Dialogue: 0,0:02:06.33,0:02:08.46,Default,,0000,0000,0000,,Guys, the memory trick is the old dudes
Dialogue: 0,0:02:08.46,0:02:11.61,Default,,0000,0000,0000,,like grumpy old men who have\Nbeen here for a long time
Dialogue: 0,0:02:11.61,0:02:14.88,Default,,0000,0000,0000,,they're past their peak and\Nthey never mix well with others.
Dialogue: 0,0:02:14.88,0:02:16.71,Default,,0000,0000,0000,,They're basically antisocial.
Dialogue: 0,0:02:16.71,0:02:21.12,Default,,0000,0000,0000,,So the keywords, draw up\Nin two separate syringes.
Dialogue: 0,0:02:21.12,0:02:24.09,Default,,0000,0000,0000,,So remember, Detemir lasts all year
Dialogue: 0,0:02:24.09,0:02:27.09,Default,,0000,0000,0000,,and Glargine is large, lasting
Dialogue: 0,0:02:27.09,0:02:31.26,Default,,0000,0000,0000,,and Lantus is like a\Nlanturn, it burns all night.
Dialogue: 0,0:02:31.26,0:02:34.02,Default,,0000,0000,0000,,Now number four here guys,\Na big NCLEX favorite.
Dialogue: 0,0:02:34.02,0:02:35.42,Default,,0000,0000,0000,,They're gonna try and trick you.
Dialogue: 0,0:02:35.42,0:02:39.63,Default,,0000,0000,0000,,So the IV only insulin is regular insulin.
Dialogue: 0,0:02:39.63,0:02:41.34,Default,,0000,0000,0000,,So remember a memory trick here.
Dialogue: 0,0:02:41.34,0:02:43.69,Default,,0000,0000,0000,,Regular insulin is ready to go IV
Dialogue: 0,0:02:44.67,0:02:47.70,Default,,0000,0000,0000,,or regular is right in the vein.
Dialogue: 0,0:02:47.70,0:02:50.73,Default,,0000,0000,0000,,Not NPH, not Lispro, not Lantus guys.
Dialogue: 0,0:02:50.73,0:02:52.62,Default,,0000,0000,0000,,No one except regular.
Dialogue: 0,0:02:52.62,0:02:54.18,Default,,0000,0000,0000,,He's the VIP for the IV.
Dialogue: 0,0:02:55.11,0:02:59.82,Default,,0000,0000,0000,,Now number five, we draw up\Ninsulin always clear to cloudy.
Dialogue: 0,0:02:59.82,0:03:01.41,Default,,0000,0000,0000,,Guys, just think you want clear days
Dialogue: 0,0:03:01.41,0:03:03.21,Default,,0000,0000,0000,,before you want cloudy ones.
Dialogue: 0,0:03:03.21,0:03:04.92,Default,,0000,0000,0000,,So draw up regular insulin first
Dialogue: 0,0:03:04.92,0:03:08.76,Default,,0000,0000,0000,,the clear and then NPH the cloudy second.
Dialogue: 0,0:03:08.76,0:03:12.24,Default,,0000,0000,0000,,Six, we rotate locations\Nevery two or three weeks
Dialogue: 0,0:03:12.24,0:03:15.03,Default,,0000,0000,0000,,and the best location is\Nalways on the abdomen.
Dialogue: 0,0:03:15.03,0:03:19.23,Default,,0000,0000,0000,,Keywords here near the\NUmbilicus, naval or belly button.
Dialogue: 0,0:03:19.23,0:03:21.42,Default,,0000,0000,0000,,And guys, we never aspirate.
Dialogue: 0,0:03:21.42,0:03:23.61,Default,,0000,0000,0000,,Basically never draw back on that plunger.
Dialogue: 0,0:03:23.61,0:03:26.04,Default,,0000,0000,0000,,It'll cause scar tissue and swelling.
Dialogue: 0,0:03:26.04,0:03:27.66,Default,,0000,0000,0000,,And also we never massage
Dialogue: 0,0:03:27.66,0:03:30.27,Default,,0000,0000,0000,,or add heat after sub-Q injections.
Dialogue: 0,0:03:30.27,0:03:32.61,Default,,0000,0000,0000,,Now lastly, number seven, DKA
Dialogue: 0,0:03:32.61,0:03:36.06,Default,,0000,0000,0000,,the extreme high sugar\Ncondition in type one diabetes.
Dialogue: 0,0:03:36.06,0:03:38.07,Default,,0000,0000,0000,,Guys, we have a separate video for that
Dialogue: 0,0:03:38.07,0:03:40.41,Default,,0000,0000,0000,,but here's the big NCLEX question here.
Dialogue: 0,0:03:40.41,0:03:43.80,Default,,0000,0000,0000,,Do we give insulin on sick days?
Dialogue: 0,0:03:43.80,0:03:45.00,Default,,0000,0000,0000,,What if the patient's not eating
Dialogue: 0,0:03:45.00,0:03:47.16,Default,,0000,0000,0000,,or basically too nauseous to eat?
Dialogue: 0,0:03:47.16,0:03:50.07,Default,,0000,0000,0000,,Well, yes, we give insulin without food
Dialogue: 0,0:03:50.07,0:03:52.98,Default,,0000,0000,0000,,we just monitor that glucose closely.
Dialogue: 0,0:03:52.98,0:03:56.13,Default,,0000,0000,0000,,So remember, we always\Nincrease the insulin
Dialogue: 0,0:03:56.13,0:03:58.53,Default,,0000,0000,0000,,during the Ss, like stress, like surgery
Dialogue: 0,0:03:58.53,0:04:02.55,Default,,0000,0000,0000,,sepsis or infection, and\Neven sickness and steroids.
Dialogue: 0,0:04:02.55,0:04:04.29,Default,,0000,0000,0000,,Now, as far as insulin types
Dialogue: 0,0:04:04.29,0:04:07.41,Default,,0000,0000,0000,,who put sugar and\Npotassium into the cells.
Dialogue: 0,0:04:07.41,0:04:10.02,Default,,0000,0000,0000,,Now these are must knows\Nfor the NCLEX specifically
Dialogue: 0,0:04:10.02,0:04:12.06,Default,,0000,0000,0000,,the peak times, coming up 60%
Dialogue: 0,0:04:12.06,0:04:14.52,Default,,0000,0000,0000,,of the time and all endocrine questions.
Dialogue: 0,0:04:14.52,0:04:17.10,Default,,0000,0000,0000,,And a little FYI for the NCLEX guys
Dialogue: 0,0:04:17.10,0:04:18.90,Default,,0000,0000,0000,,we're not using brand names anymore.
Dialogue: 0,0:04:18.90,0:04:20.07,Default,,0000,0000,0000,,Only generic.
Dialogue: 0,0:04:20.07,0:04:22.44,Default,,0000,0000,0000,,So no more Novolog or Novolin.
Dialogue: 0,0:04:22.44,0:04:23.80,Default,,0000,0000,0000,,If your school's still using this
Dialogue: 0,0:04:23.80,0:04:25.86,Default,,0000,0000,0000,,then they're behind on the times.
Dialogue: 0,0:04:25.86,0:04:27.42,Default,,0000,0000,0000,,So again, for reinforcement
Dialogue: 0,0:04:27.42,0:04:30.36,Default,,0000,0000,0000,,our first group is the long acting guys
Dialogue: 0,0:04:30.36,0:04:32.19,Default,,0000,0000,0000,,our antisocial old dudes, guys
Dialogue: 0,0:04:32.19,0:04:35.40,Default,,0000,0000,0000,,they have no peak and\Nnever mix with others.
Dialogue: 0,0:04:35.40,0:04:37.26,Default,,0000,0000,0000,,Big NCLEX keyword again
Dialogue: 0,0:04:37.26,0:04:40.80,Default,,0000,0000,0000,,draw up in separate syringes, never mix.
Dialogue: 0,0:04:40.80,0:04:43.71,Default,,0000,0000,0000,,These guys have no peaks,\Nso they require no plates
Dialogue: 0,0:04:43.71,0:04:46.38,Default,,0000,0000,0000,,or basically they're not food dependent
Dialogue: 0,0:04:46.38,0:04:48.15,Default,,0000,0000,0000,,and hence they have a minimal risk
Dialogue: 0,0:04:48.15,0:04:50.52,Default,,0000,0000,0000,,for that hypo low sugar.
Dialogue: 0,0:04:50.52,0:04:52.38,Default,,0000,0000,0000,,So the brain is pretty safe here.
Dialogue: 0,0:04:52.38,0:04:56.22,Default,,0000,0000,0000,,Again, our memory trick here\Nis Detemir lasts all year.
Dialogue: 0,0:04:56.22,0:05:01.22,Default,,0000,0000,0000,,It's long lasting and\NGlargine is large lasting.
Dialogue: 0,0:05:01.23,0:05:04.38,Default,,0000,0000,0000,,Now NPH are cloudy,\Ndude, always being mixed.
Dialogue: 0,0:05:04.38,0:05:07.74,Default,,0000,0000,0000,,So remember the Ns intermediate insulin
Dialogue: 0,0:05:07.74,0:05:11.31,Default,,0000,0000,0000,,and we never give it IV drip or bag.
Dialogue: 0,0:05:11.31,0:05:14.19,Default,,0000,0000,0000,,Guys never put anything\Ncloudy in an IV bag.
Dialogue: 0,0:05:14.19,0:05:17.70,Default,,0000,0000,0000,,Now when we do mix it\Nalways mix clear to cloudy,
Dialogue: 0,0:05:17.70,0:05:19.83,Default,,0000,0000,0000,,clear days before cloudy.
Dialogue: 0,0:05:19.83,0:05:22.34,Default,,0000,0000,0000,,So we usually give NPH two times per day
Dialogue: 0,0:05:22.34,0:05:24.24,Default,,0000,0000,0000,,not four times a day.
Dialogue: 0,0:05:24.24,0:05:26.61,Default,,0000,0000,0000,,So don't let the NCLEX trick you.
Dialogue: 0,0:05:26.61,0:05:29.76,Default,,0000,0000,0000,,Now the peak time is\Nbetween four and 12 hours
Dialogue: 0,0:05:29.76,0:05:33.81,Default,,0000,0000,0000,,but most dangerous in the\Nmiddle, around five to six hours.
Dialogue: 0,0:05:33.81,0:05:36.78,Default,,0000,0000,0000,,So make sure you have a\Nplate of food with that peak.
Dialogue: 0,0:05:36.78,0:05:40.14,Default,,0000,0000,0000,,Next is regular insulin,\Nthat's ready to go IV.
Dialogue: 0,0:05:40.14,0:05:44.82,Default,,0000,0000,0000,,Guys again, he's the only dude\Nallowed IV push or IV bag.
Dialogue: 0,0:05:44.82,0:05:47.67,Default,,0000,0000,0000,,If you haven't wrote that\Ndown, please write it down.
Dialogue: 0,0:05:47.67,0:05:50.16,Default,,0000,0000,0000,,His peak is between two and four hours.
Dialogue: 0,0:05:50.16,0:05:52.08,Default,,0000,0000,0000,,So monitor closely for signs
Dialogue: 0,0:05:52.08,0:05:55.32,Default,,0000,0000,0000,,of low sugar, that shaky,\Npale, cool, and clammy.
Dialogue: 0,0:05:55.32,0:05:57.90,Default,,0000,0000,0000,,We need to give some sugary candy.
Dialogue: 0,0:05:57.90,0:06:00.48,Default,,0000,0000,0000,,Now finally, our most deadly insulins.
Dialogue: 0,0:06:00.48,0:06:02.34,Default,,0000,0000,0000,,They're the number one priority
Dialogue: 0,0:06:02.34,0:06:04.80,Default,,0000,0000,0000,,since they have the\Nnumber one fastest peak
Dialogue: 0,0:06:04.80,0:06:09.80,Default,,0000,0000,0000,,and onset, 15 minute onset guys\Nwith a 30 to 90 minute peak.
Dialogue: 0,0:06:10.32,0:06:11.76,Default,,0000,0000,0000,,So rapid acting insulin.
Dialogue: 0,0:06:11.76,0:06:15.45,Default,,0000,0000,0000,,Remember, Lispro, Aspart and Glulisine.
Dialogue: 0,0:06:15.45,0:06:17.82,Default,,0000,0000,0000,,So memory tricks here for Aspart
Dialogue: 0,0:06:17.82,0:06:20.22,Default,,0000,0000,0000,,you gotta remember to move your ASS-parts.
Dialogue: 0,0:06:20.22,0:06:22.23,Default,,0000,0000,0000,,Guys, it's really fast.
Dialogue: 0,0:06:22.23,0:06:24.63,Default,,0000,0000,0000,,And Lispro, Just think LESSpro,
Dialogue: 0,0:06:24.63,0:06:27.90,Default,,0000,0000,0000,,less time for the onset it's 15 minutes.
Dialogue: 0,0:06:27.90,0:06:31.63,Default,,0000,0000,0000,,And Glulisine, it goes\Nfast like a limousine.
Dialogue: 0,0:06:31.63,0:06:32.46,Default,,0000,0000,0000,,It's super fast.
Dialogue: 0,0:06:32.46,0:06:34.35,Default,,0000,0000,0000,,So we give these during meals.
Dialogue: 0,0:06:34.35,0:06:35.43,Default,,0000,0000,0000,,Keyword here,
Dialogue: 0,0:06:35.43,0:06:38.55,Default,,0000,0000,0000,,patient is eating or\Nthere's food at the bedside.
Dialogue: 0,0:06:38.55,0:06:42.27,Default,,0000,0000,0000,,Again, guys, patient must be\Neating in 10 to 15 minutes,
Dialogue: 0,0:06:42.27,0:06:44.37,Default,,0000,0000,0000,,not before the food's delivered.
Dialogue: 0,0:06:44.37,0:06:46.23,Default,,0000,0000,0000,,Usually an NCLEX question.
Dialogue: 0,0:06:46.23,0:06:48.93,Default,,0000,0000,0000,,Those peak times are the\Nmust knows for the NCLEX.
Dialogue: 0,0:06:48.93,0:06:51.06,Default,,0000,0000,0000,,So I'd recommend printing\Nthis study guide out
Dialogue: 0,0:06:51.06,0:06:54.03,Default,,0000,0000,0000,,and reviewing it every day\Nat the week of your exam.
Dialogue: 0,0:06:54.03,0:06:55.29,Default,,0000,0000,0000,,Now, little insulin quiz.
Dialogue: 0,0:06:55.29,0:06:58.71,Default,,0000,0000,0000,,We're covering the top three\Nmost tested NCLEX questions
Dialogue: 0,0:06:58.71,0:06:59.85,Default,,0000,0000,0000,,on peak times.
Dialogue: 0,0:06:59.85,0:07:00.88,Default,,0000,0000,0000,,Here we go.
Dialogue: 0,0:07:00.88,0:07:03.48,Default,,0000,0000,0000,,Again, peaks are priorities.
Dialogue: 0,0:07:03.48,0:07:06.36,Default,,0000,0000,0000,,The fastest way to kill your\Npatient is not giving a plate
Dialogue: 0,0:07:06.36,0:07:07.89,Default,,0000,0000,0000,,of food with the peaks.
Dialogue: 0,0:07:07.89,0:07:10.08,Default,,0000,0000,0000,,So remember, peaks require plates.
Dialogue: 0,0:07:10.08,0:07:13.08,Default,,0000,0000,0000,,So we drew a little plate on\Nthe flag showing the peak time.
Dialogue: 0,0:07:13.08,0:07:16.50,Default,,0000,0000,0000,,Now our red rapid guys\Nare the most deadly.
Dialogue: 0,0:07:16.50,0:07:21.24,Default,,0000,0000,0000,,Always monitor for hypoglycemia,\Nthat low sugar below 70
Dialogue: 0,0:07:21.24,0:07:24.30,Default,,0000,0000,0000,,you're gonna see shaky,\Nsweaty, pale, and clammy.
Dialogue: 0,0:07:24.30,0:07:28.65,Default,,0000,0000,0000,,So we give that patient some\Nsweet juice, soda, or candy.
Dialogue: 0,0:07:28.65,0:07:29.91,Default,,0000,0000,0000,,Okay, question number one,
Dialogue: 0,0:07:29.91,0:07:33.99,Default,,0000,0000,0000,,The nurse gives regular\Ninsulin at 12:00 PM for lunch
Dialogue: 0,0:07:33.99,0:07:36.45,Default,,0000,0000,0000,,but the patient doesn't finish their food.
Dialogue: 0,0:07:36.45,0:07:40.08,Default,,0000,0000,0000,,So when's the greatest\Nrisk for that hypoglycemia?
Dialogue: 0,0:07:40.08,0:07:41.85,Default,,0000,0000,0000,,Guys, the risk for regular,
Dialogue: 0,0:07:41.85,0:07:44.76,Default,,0000,0000,0000,,look at the peaks right\Nhere, two to four hours.
Dialogue: 0,0:07:44.76,0:07:46.62,Default,,0000,0000,0000,,So if given at 12, the answer's
Dialogue: 0,0:07:46.62,0:07:51.27,Default,,0000,0000,0000,,between 2:00 PM and 4:00 PM\Nnever before and not after.
Dialogue: 0,0:07:51.27,0:07:54.15,Default,,0000,0000,0000,,So guys memorize these peak times.
Dialogue: 0,0:07:54.15,0:07:57.33,Default,,0000,0000,0000,,Now, question number two, A\Nclient is on Aspart insulin,
Dialogue: 0,0:07:57.33,0:07:59.73,Default,,0000,0000,0000,,when should the nurse advise him to eat?
Dialogue: 0,0:07:59.73,0:08:02.07,Default,,0000,0000,0000,,Again, guys, this is\Nan onset of 15 minutes
Dialogue: 0,0:08:02.07,0:08:04.95,Default,,0000,0000,0000,,with apeak time between 30 to 90 minutes.
Dialogue: 0,0:08:04.95,0:08:07.89,Default,,0000,0000,0000,,So Aspart get your ASS-parts moving
Dialogue: 0,0:08:07.89,0:08:09.57,Default,,0000,0000,0000,,the best answer is the soonest.
Dialogue: 0,0:08:09.57,0:08:13.11,Default,,0000,0000,0000,,So eating within 10 or 15 minutes.
Dialogue: 0,0:08:13.11,0:08:14.85,Default,,0000,0000,0000,,Now question number three, the client
Dialogue: 0,0:08:14.85,0:08:16.74,Default,,0000,0000,0000,,on Glargine is asking the nurse
Dialogue: 0,0:08:16.74,0:08:20.34,Default,,0000,0000,0000,,When is the best time to\Neat during this insulin?
Dialogue: 0,0:08:20.34,0:08:22.92,Default,,0000,0000,0000,,Well, guys, Glargine is large lasting,
Dialogue: 0,0:08:22.92,0:08:24.90,Default,,0000,0000,0000,,long acting, no peaks.
Dialogue: 0,0:08:24.90,0:08:27.27,Default,,0000,0000,0000,,So no peaks require no plates.
Dialogue: 0,0:08:27.27,0:08:28.98,Default,,0000,0000,0000,,Pretty tricky one there.
Dialogue: 0,0:08:28.98,0:08:30.36,Default,,0000,0000,0000,,Now for a little bonus question
Dialogue: 0,0:08:30.36,0:08:32.79,Default,,0000,0000,0000,,we saw this a few times\Nin our NCLEX review.
Dialogue: 0,0:08:32.79,0:08:37.79,Default,,0000,0000,0000,,So the client taking insulin\NNPH with dinner at 7:00 PM
Dialogue: 0,0:08:37.80,0:08:39.54,Default,,0000,0000,0000,,What time is the client most
Dialogue: 0,0:08:39.54,0:08:43.17,Default,,0000,0000,0000,,at risk for that hypo low sugar?
Dialogue: 0,0:08:43.17,0:08:47.55,Default,,0000,0000,0000,,So NPH has a four to 12 hour\Npeak, the most at risk guys
Dialogue: 0,0:08:47.55,0:08:49.71,Default,,0000,0000,0000,,we're looking at the green peak here.
Dialogue: 0,0:08:49.71,0:08:53.85,Default,,0000,0000,0000,,5.5 to six hours has the most peak.
Dialogue: 0,0:08:53.85,0:08:57.84,Default,,0000,0000,0000,,So the best answer here is\Nmidnight or shortly after.
Dialogue: 0,0:08:57.84,0:09:00.93,Default,,0000,0000,0000,,Now, before we move on to the\Ninsulin infusion pump, guys
Dialogue: 0,0:09:00.93,0:09:03.36,Default,,0000,0000,0000,,the best way to memorize\Nthese insulin peak times
Dialogue: 0,0:09:03.36,0:09:05.97,Default,,0000,0000,0000,,is to print off the study guide\Nor cheat sheet we provide.
Dialogue: 0,0:09:05.97,0:09:06.93,Default,,0000,0000,0000,,And guys, write this out
Dialogue: 0,0:09:06.93,0:09:10.11,Default,,0000,0000,0000,,at least seven to 15 times\Nthe week of your exam.
Dialogue: 0,0:09:10.11,0:09:12.90,Default,,0000,0000,0000,,Now for insulin pumps or CSII
Dialogue: 0,0:09:12.90,0:09:16.47,Default,,0000,0000,0000,,the continuous subcutaneous\Ninsulin infusion, guys
Dialogue: 0,0:09:16.47,0:09:18.54,Default,,0000,0000,0000,,the number one benefit is the steady dose
Dialogue: 0,0:09:18.54,0:09:21.90,Default,,0000,0000,0000,,of insulin for our type\None kids who forget to
Dialogue: 0,0:09:21.90,0:09:24.33,Default,,0000,0000,0000,,take their insulin and are\Nbasically non-compliant.
Dialogue: 0,0:09:24.33,0:09:26.76,Default,,0000,0000,0000,,The biggest benefit and\Nthe coolest part here
Dialogue: 0,0:09:26.76,0:09:29.40,Default,,0000,0000,0000,,is we have fewer swings\Nin blood sugar level.
Dialogue: 0,0:09:29.40,0:09:32.01,Default,,0000,0000,0000,,So not high or not low anymore, guys.
Dialogue: 0,0:09:32.01,0:09:34.11,Default,,0000,0000,0000,,It's a nice even basal rate.
Dialogue: 0,0:09:34.11,0:09:36.84,Default,,0000,0000,0000,,That's a big key word, even basal rate.
Dialogue: 0,0:09:36.84,0:09:38.04,Default,,0000,0000,0000,,Now, how do you manage it?
Dialogue: 0,0:09:38.04,0:09:41.01,Default,,0000,0000,0000,,Well, we usually check the\Nblood sugar four times per day
Dialogue: 0,0:09:41.01,0:09:45.21,Default,,0000,0000,0000,,and you push keyword there,\Npush an insulin bolus button
Dialogue: 0,0:09:45.21,0:09:48.30,Default,,0000,0000,0000,,at meal times to get\Nthat sugar into the cell.
Dialogue: 0,0:09:48.30,0:09:49.89,Default,,0000,0000,0000,,Now what if you get an NCLEX question
Dialogue: 0,0:09:49.89,0:09:53.07,Default,,0000,0000,0000,,about a machine malfunctioning\Nguys, what do you do?
Dialogue: 0,0:09:53.07,0:09:54.27,Default,,0000,0000,0000,,Do you assess the patient
Dialogue: 0,0:09:54.27,0:09:56.58,Default,,0000,0000,0000,,or do you assess the machine first?
Dialogue: 0,0:09:56.58,0:10:00.18,Default,,0000,0000,0000,,Hmm, well, we always\Nassess the patient first
Dialogue: 0,0:10:00.18,0:10:01.83,Default,,0000,0000,0000,,and then machine second.
Dialogue: 0,0:10:01.83,0:10:03.66,Default,,0000,0000,0000,,Now that's really big on the NCLEX.
Dialogue: 0,0:10:03.66,0:10:04.86,Default,,0000,0000,0000,,Thanks for watching.
Dialogue: 0,0:10:04.86,0:10:06.86,Default,,0000,0000,0000,,For our full video and new quiz bank
Dialogue: 0,0:10:06.86,0:10:09.18,Default,,0000,0000,0000,,click right up here to\Naccess your free trial
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Dialogue: 0,0:10:12.33,0:10:14.28,Default,,0000,0000,0000,,Last but not least, a big thanks
Dialogue: 0,0:10:14.28,0:10:17.40,Default,,0000,0000,0000,,to our team of experts helping\Nus make these great videos.
Dialogue: 0,0:10:17.40,0:10:18.23,Default,,0000,0000,0000,,All right guys.
Dialogue: 0,0:10:18.23,0:10:19.65,Default,,0000,0000,0000,,See you next time.
Dialogue: 0,0:10:19.65,0:10:22.15,Default,,0000,0000,0000,,(light music)