Anti-Diabetic PREPU
Amylin is a peptide hormone secreted with insulin by the beta cells of the pancreas and is important in the regulation of glucose control during the postprandial period. True or false?
True Rationale: Pramlintide (Symlin) is a synthetic analog of amylin, a peptide hormone secreted with insulin by the beta cells of the pancreas, important in the regulation of glucose control during the postprandial period.
Which of the following is an example of rapid acting insulin?
Insulin lispro (Humalog) Rationale: Insulin lispro (Humalog) is an example of rapid acting insulin.
A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?
Observe the patient for hypoglycemic episodes. Rationale: As the ongoing assessment activity, the nurse should observe the patient for hypoglycemic episodes. Documenting family medical history and assessing the patient's skin for ulcers, cuts, and sores on the body is a pre-administration assessment activity performed by the nurse. Lipodystrophy occurs if the sites of insulin injection are not rotated.
Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which of the following actions does this enable?
Entry of glucose into the cells Rationale: After insulin-receptor binding occurs, cell membranes become highly permeable to glucose and allow rapid entry of glucose into the cells.
The nurse is interviewing a client who was diagnosed with type 2 diabetes about four months ago. The client never records glucometer readings but says that everything is just fine. What laboratory test does the nurse anticipate the health care provider will order for this client?
HbA1c Rationale: The nurse anticipates that the glycosylated hemoglobin (HbA1c) will be ordered for this client because it provides an average of the client's blood glucose level for the last three- to four-month period. It will also tell how well controlled the client's blood glucose is. A stat urine for glucose and an FBG in the AM will only indicate the client's current blood glucose level, not how well it is being controlled. An insulin level will not give the information needed to understand the client's control of blood glucose.
The physician has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which of the following adverse effects must the nurse closely monitor for in the patient?
Hypoglycemia Rationale: Changing the type of insulin requires caution, and the patient should be carefully monitored for hypoglycemia or hyperglycemia, either of which may occur as the body adjusts to the different pharmacokinetics of the preparation. However, hypoglycemia may cause an increased sympathetic activity and manifest as tachycardia. Lipodystrophy is caused by the breakdown of subcutaneous fat because of repeated insulin injections at the same site. A change of insulin prescription is not known to cause hypotension.
A patient is receiving acarbose. Which of the following would the nurse incorporate into the teaching plan for this patient about the action of the drug?
Inhibits an enzyme to delay glucose absorption Rationale: Acarbose inhibits alpha glucosidase, an enzyme, thereby delaying the absorption of glucose. Thiazolidinediones, such as rosiglitazone, decrease insulin resistance. Second generation sulfonylureas bind to potassium channels on the pancreatic beta cells to improve insulin binding to insulin receptors and increase the number of insulin receptors. Biguanides, such as metformin, increase the uptake of glucose.
Which of the following would be appropriate to include in teaching your client with type 2 diabetes?
It is possible with weight loss and exercise to discontinue the use of antidiabetic medication. Rationale: Exercise is perhaps the best therapy for the prevention of both type 2 diabetes and the metabolic syndrome. Exercise is an extremely strong hypoglycemic agent.
The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's top priority intervention related to this medication?
Make sure the client's breakfast is available in the next 5-10 minutes. Rationale: Insulin lispro has an onset of 5-10 minutes, so it is most important to ensure that there is food for the client after administration. Its peak is 30 min-1.5 hours so blood sugar would be most affected between 7:30 AM and 8:30 AM. Cleansing the site with soap and water is not necessary unless there is visible dirt on the skin, and lying quietly is not an intervention.
Glycosylated hemoglobin measures average blood glucose over what time period? (Choose one)
The past 3 or 4 months Rationale: Glycosylated hemoglobin measures glucose control over the past 2 or 3 months.