CP- Drug Therapy for Diabetes Mellitus

A young man has been diagnosed with type 2 diabetes and has been prescribed glyburide. Which statement suggests that the nurse should perform further health education?

"I'll plan to take my glyburide each night before I go to bed." Glyburide is normally taken in the morning, before breakfast. No drug cures diabetes; the goal of therapy is the maintenance of safe blood glucose levels. The client should check before taking other drugs and should indeed be aware of the risk of hypoglycemia.

What instructions would be important to give to a 50-year-old client with type 2 diabetes who has been switched from glyburide , a sulfonylurea, to repaglinide, a meglitinide?

"It stimulates insulin production, so you need to eat soon after taking the medication."

A 59-year-old man with type 2 diabetes is prescribed metformin. When the client returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond?

"Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy."

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?

06:45 With short-acting insulins like lispro, aspart, or glulisine, it is important to inject the medication about 15 minutes before eating.

The nurse is preparing to administer insulin glargine to a client. Which actions will the nurse perform when preparing the insulin? Select all that apply. Check the expiration date on the vial. Shake the vial vigorously. Check the health care provider's orders for the type and dosage of insulin. Remove all air bubbles from the syringe barrel. Mix with short-acting insulin prior to administration.

Check the expiration date on the vial. Check the health care provider's orders for the type and dosage of insulin. Remove all air bubbles from the syringe barrel.

The nurse is assessing a client for risk factors associated with type 2 diabetes. Which findings would the nurse prioritize? Select all that apply. Younger age Impaired glucose tolerance Caucasian race Obesity History of gestational diabetes

Impaired glucose tolerance Obesity History of gestational diabetes

A nurse is preparing to administer insulin to the client. Which interventions should the nurse perform before administering each insulin dose?

Inspect the previous injection site for inflammation.

Which would be least appropriate when administering insulin by subcutaneous injection?

Massaging the site after removing the needle

A client who has been prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client?

Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.

The home care nurse is caring for an older adult client who has been diagnosed with type 1 diabetes. The client has visual impairment and cannot read the numbers on the syringe when preparing insulin for administration nor afford the cost of prefilled auto syringes. What strategy might the nurse use to help this client comply with insulin needs between visits?

Prepare a week's supply of syringes and refrigerate.

A client diagnosed with diabetic ketoacidosis has been admitted to the intensive care unit. The client is prescribed an intravenous insulin drip, so the nurse knows that what type of insulin will be administered?

Regular Regular insulin (insulin injection) has a rapid onset of action and can be given intravenously. Therefore, it is the insulin of choice during acute situations, such as DKA, severe infection or other illness, and surgical procedures. All the other options are administered subcutaneously.

A 35-year-old client has begun the administration of glyburide for treatment of diabetes mellitus type 2. The nurse caring for this client provides education regarding this medication. Which statement would NOT be an appropriate instruction for this client?

The medication should have a fixed dose which cannot be manipulated.

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin?

insulin glargine

A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action?

insulin lispro Insulin lispro has a 15-minute onset of action. NPH, 70/30, and regular insulin have longer onsets of action, a later peak, and a longer duration of action.

The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?

weakness, sweating, and decreased mentation. Symptoms of hypoglycemia include shakiness, dizziness or light-headedness, sweating, nervousness or irritability, sudden changes in behavior or mood, weakness, pale skin, and hunger. The other signs are more consistent with hyperglycemia.

A client with type 1 diabetes has a medication regimen that includes insulin NPH. The nurse has administered the scheduled dose at 0800 and will expect to first assess for the medication's onset of action at what time?

0900 NPH has an onset of 1 to 1.5 hours. Consequently, the nurse would anticipate the onset of an 0800 dose to begin at 0900.

A client at a health care facility has been prescribed 8 mg of rosiglitazone maleate (Avandia) daily to improve glycemic control. On-hand availability of the drug is in the form of 2 mg tablets. How many tablets of the drug should the nurse administer to the client?

4 tablets

The nurse is assessing a client who was administered metformin and notes hyperventilation, nausea, and somnolence. The nurse determines which nursing diagnosis should be prioritized for this client?

Altered Breathing Pattern

A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment?

Assess the most recent hemoglobin A1C levels.

A nurse is preparing to administer insulin glargine to a client. What precaution should the nurse take when administering this drug?

Avoid mixing glargine with other insulins. When administering insulin glargine to the client, the nurse should avoid mixing it with other insulins or solutions. It will precipitate in the syringe when mixed. If glargine is mixed with another solution, it will lose glucose control, resulting in decreased effectiveness of the insulin. Glargine is administered via the subcutaneous route once daily at bedtime. The nurse should not shake the vial vigorously before withdrawing insulin. The vial should be gently rotated between the palms of the hands and tilted gently end to end immediately before withdrawing the insulin. The nurse administers insulin from vials at room temperature. Vials are stored in the refrigerator if they are to be stored for about 3 months for later use.

A nurse is caring for a patient with elevated blood glucose levels receiving α-glucosidase inhibitor drug therapy. For which of the following conditions of the patient are α-glucosidase inhibitors contraindicated? Select all that apply.

Cirrhosis Chronic intestinal diseases Colonic ulceration

A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?

Client's average blood glucose is above normal.

A nurse is preparing to administer exenatide to a client with type 2 diabetes. The nurse will question this order if which condition is noted in the client's medical record?

Diabetic ketoacidosis

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which intervention should the nurse perform if swallowing and gag reflexes are present in the patient?

Give oral fluids or candy.

The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not record glucometer readings. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1c

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hyperglycemia that include which of the following? Select all that apply: Increased thirst Increased urination Increased hunger Confusion Increased perspiration

Increased thirst Increased urination Confusion

A client is receiving acarbose. What would the nurse incorporate into the teaching plan for this client about the action of the drug?

Inhibits an enzyme to delay glucose absorption

A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?

Perform a blood sugar analysis.

A 2-month-old male child is diagnosed with diabetes. His parents are having difficulty measuring 2 units of insulin in the U-100 syringe. What would the nurse expect the health care provider to order?

U-10 (10 units/mL) insulin

The nurse is caring for a postoperative client whose diabetes has been well controlled on acarbose. The client is not allowed to take anything orally following complications of abdominal surgery and is receiving high-glucose total parenteral nutrition via a central IV line. What medication can the nurse administer intravenously to control the client's blood glucose level?

regular insulin