[Applause] [Music] insulin is a hormone that is produced Naturally by the pancreas but it can also be given as a medication to people with high blood glucose levels or high potassium levels in this pneumonic video we'll cover some important facts about insulin so you'll be ready come test day a group of hikers has finally made it to the mountain peak and they were smart to bring insulation to keep them warm since mountain peaks like this are usually cold and snowy here at Pixar eyes we use insulation to symbolize insulin since insulation and Insulin sound so similar right insulin is a hormone that is made naturally in the pancreas but it can also be given as a medication via an injection there are several different types of insulin so we'll cover each of those in their own respective videos in this video we'll cover the more General facts that apply to all insulin types now that we're anchored to the scene let's move on to learn the mechanisms and clinical uses of insulin to make things easier we've clustered the mechanisms and clinical uses around the woman to the left of this Scene It took these hikers a lot longer than expected to reach the peak they brought a lot of insulation to keep them warm but now they're wishing that they would have filled their packs with more food instead the woman on the left brought along some sugar since sugar is a high calorie food which is needed on a strenuous hike like this one notice how the woman is emptying the sugar canister to make a snack sugar is our symbol for well sugar blood sugar that is also known as blood glucose the way that the woman is emptying the sugar canister should help you remember that insulin lowers blood glucose think of it like she's lowering the sugar levels in the canister just like insulin lowers sugar levels in the blood let me explain how insulin causes this decrease in blood glucose levels to review how insulin works in the body let's introduce a diagram of a cell being supplied by a blood vessel with glucose circulating in the blood insulin is a hormone that the body uses to control blood glucose levels it does this by binding to receptors on cells of our body the insulin binding activates a chain reaction that tells the cell to put glucose Transporters on its cell membrane this presence of glucose transporters then allows glucose to enter the cell from the bloodstream causing a decrease in blood glucose levels I mentioned that insulin is made naturally in the pancreas so if the body already makes insulin why does some people need insulin injections let's move on to find out before taking a bite of the sugary snack the woman decides it would be best to check her blood sugar with her diabetes sugar monitor this woman has diabetes and she's extra worried about her blood sugar levels after such a strenuous hike up to the peak this diabetes sugar monitor should help you remember the treatment of diabetes melodus more commonly known as simply diabetes since every person with diabetes always gets a monitor to know when they need treatment right diabetes is a disease characterized by high blood glucose levels it can be broken down into type 1 diabetes where the pancreas does not make enough insulin and and type 2 diabetes where the cells become less responsive to insulin while we won't go into any more detail about the differences in type 1 and type 2 diabetes in this video remember that insulin is the primary treatment for type 1 diabetes and insulin is usually used as a supplemental treatment for type 2 diabetes along with other forms of treatment like Diet exercise and oral medications but in both cases of diabetes blood glucose levels become really high and in the way we mentioned earlier insulin can be given to lower those blood glucose levels while lowering blood glucose is the most common use of insulin there's another reason why we give insulin that you should know let's talk about that next like I mentioned before the hikers are running out of food and the woman has used the very last banana in her sugary snack since there aren't garbage cans on a mountain peak the woman is dropping the banana peel so it falls down off the cliff thinking that it'll decompose quickly into the mountain soil let's take a closer look at the banana peel here at Pixar eyes we use bananas to symbolize potassium since bananas have a lot of potassium right the way this banana peel is empty and falling should help you remember that insulin lowers potassium patients who present with really high potassium levels called hyperemia may be given Ivy insulin as a way to lower potassium back to a normal level using insulin to treat hyperkalemia isn't as common as using insulin to treat high blood glucose but you may come across it in the clinical setting or on test day so it's definitely good to know now that we know the uses of insulin let's move on to its potential side effects for your convenience these are clustered around another hiker towards the back of the scene it was obvious this little bit of sugar mixed with a banana wasn't going to be enough to feed the group of hungry hikers so this man in the middle took it upon himself to hunt down an animal his successful hunt has left him with a large slab of meat he even saved the animals extra fat so the hikers can get as many calories as possible as you can see the man is injecting the animals extra fat into the meat creating a big lump of fat under its surface the way this fat is creating a lump in the meat reminds me of how insulin can cause lipo hypertrophy lipo hypertrophy is a fancy term for a lump of fat that forms Under the Skin and it happens from repeated injections in the same spot it becomes a problem because the fat deposit affects the way the body absorbs insulin lipo hypertrophy can be prevented and we'll talk about how to prevent it later in this video when we talk about insulin Administration one of the empty sugar canisters has rolled down the mountain away from the woman and towards the hiker with the meat you already know that this empty sugar canister symbolizes lowering blood glucose levels but I wanted to point out that if too much insulin is given the blood glucose levels can drop too low when blood glucose levels drop below the recommended threshold it is called hypoglycemia severe hypoglycemia can become really dangerous to the patient if not treated with urgency it's important that you as the nurse know when a patient is most likely to experience hyp hypoglycemia as well as what to do if hypoglycemia from insulin overdose occurs let's talk about both of those things next the gleaming sugar canister caught the eye of a nearby bird which then swooped down and picked it up in its Talons as it was flying away an asteroid suddenly entered the atmosphere frightening the bird and causing it to drop the empty sugar canister right on the mountain peak we'll talk more about this asteroid later but for now focus on the empty sugar canister at the peak of the mountain since the empty sugar canister symbolizes hypoglycemia use the empty sugar canister on the peak to help you remember that hypoglycemia is most likely to occur when the insulin level in the blood is at its peak let me explain what I mean by using this chart with the xais marking time after the insulin injection and the Y AIS marking the insulin levels in the blood each type of insulin has an onset meaning when the insulin's effect starts a peak meaning when the levels of insulin in the blood are the highest and its effect is the most powerful and a duration meaning how long the insulin's effect lasts it's at the peak when insulin's effect is the most powerful that the blood glucose level is most likely to fall dangerously low a condition called hypoglycemia because remember insulin lowers blood glucose so high insulin levels means low blood glucose levels right the peak time will be different for each type of insulin and we teach you how to remember those specific peak times in our other insulin videos so be sure to take a look but for now just know that it's at the insulin peak times that you as the nurse should be extra aware of signs of hypoglycemia in your patient these mountain peaks are sharp and when the empty sugar canister landed on the peak it broke normally the hiker wouldn't care too much about a broken sugar canister but being on a mountain peak with so few resources has changed his perspective and he doesn't want anything to go to waste that's why he's pulled out his glue gun to fix the broken empty sugar canister here at Pixar eyes we use a glue gun to symbolize glucagon it's the glucagon glue gun and the way that this glue Gan is fixing the empty sugar canister can remind you that glucagon is used to fix or treat hypoglycemia caused by too much insulin when hypoglycemia is mild the patient can simply eat or drink something high in sugar to get those blood glucose levels back within normal limits however when the patient is so hypoglycemic that they're losing Consciousness you don't want to give them food or drink because they're at a high risk for aspiration that's where glucagon comes into play glucagon is similar to insulin in that it's also a hormone naturally made in the body and like insulin it can also be given as a medication but glucagon's effects are basically the opposite of insulins glucagon increases blood glucose levels you can even think of glucagon as the antidote to insulin now that we know the side effects to watch out for with insulin let's move on to talk about some Administration related facts you should know these are clustered to the right of the scene the strenuous climb to the peak combined with the high altitude has caused one of the hikers to start feeling sick luckily there's a doctor among the group of hikers the doctor is prepared to give the sick hiker an injection and because they don't speak the same language he is using a rotating wheel with various body parts to ask the woman where she wants the injection take a closer look at this rotating wheel and notice that each body part is a possible injection site for insulin and the way this wheel rotates can help you remember that when administer during insulin it's important to rotate injection sites what I mean by rotate injection sites is that each time insulin is given it should be given in a different location this is tied back to the idea of lipo hypertrophy that we talked about earlier by rotating injection sites you prevent those fat deposits from forming under the skin in this next section we're going to cover three situations when patients might need to increase their insulin dose to symbolize this we've clustered these symbols to the right of the scene where there is an increased amount of insulation use this extra insulation to help you remember when patients need extra insulin these next three topics come up in test questions all the time so pay attention here the doctor thought it would be a good idea to get the sick hiker wrapped up in extra insulation because sick people often feel extra cold right hopefully the warmth from the extra insulation will speed up her recovery use this sick person with an increased amount of insulation to remind you that sick people need increased insulin in other words you may need to increase insulin with sickness this is an important aspect of patient teaching you may hear people think they don't need to take insulin when they're sick since they're vomiting or they're not eating as much food this is actually not the case sickness causes a stress response in the body and part of this stress response is an increased in blood glucose levels so even if the patient is vomiting or has a loss of appetite they still need to take their insulin like normal and they may even need to increase the amount of insulin this might seem a little counterintuitive so that's why the enlex loves to include this concept in their test questions because the sick person is unable to help with the food Scavenging and preparation she was the first one to notice the asteroid shoot across the sky you sure do get a good view of the asteroid up here on the mountain far away from the light pollution of the city below here at Pixar eyes we use an asteroid to symbolize steroids because asteroid and steroid are so similar in spelling right another time when a person may need to increase their insulin dosages is with the use of steroids steroids are known to increase blood glucose levels so a larger dose of insulin may be needed to keep these blood glucose levels with normal limits if a patient who takes insulin also starts taking a steroid remind them that they may need to increase their insulin dosages the doctor is used to dealing with sick people but asteroids are way out of his comfort zone seeing the asteroid has made him super stressed the way that the doctor is stressed can help you remember that insulin dosages may need to be increased with stress this can be emotional stress like stressing over an a asteroid or this can be physical stress like infection surgery or illness when the body experiences stress it releases extra glucose into the bloodstream as a way to make sure the body has enough energy available to deal with the stress with extra glucose comes the need for extra insulin remind your patients that during times of emotional or physical stress they may need to increase their insulin dosages to control their blood sugar to quickly review insulin dosages might need to be increased with sickness steroids and stress if it helps they all start with the letter s all right that's all for this pneumonic let's recap insulin is a hormone produced by the pancreas that can also be given as a medication through an injection insulin lowers blood glucose making it important in the treatment of diabetes melodus insulin can also be used to lower potassium levels so you may also see it used to treat hyperemia side effects to be aware of include lipo hypertrophy and hypoglycemia hypoglycemia is most likely to occur at insulin peak times and if the hypoglycemia becomes severe enough that the patient loses Consciousness glucagon can be given to treat severe hypoglycemia when administering insulin be sure to rotate injection sites to avoid lipo hypertrophy insulin dosages may need to be increased in times of sickness with use of steroids and when the body is experiencing stress and now we're actually done with insulin see you next time thanks for watching for more videos like this one subscribe to our Channel and check out our newest lessons I'll see you next time