Pharm Chapter 41 diabetes

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A nurse has determined a client has developed a hypoglycemic reaction. Which interventions should the nurse perform if the client can adequately demonstrate swallowing and gag reflexes?

give oral fluids or candy

what insulin has the shortest onset

glulisine

A healthcare provider is planning to prescribe a second-generation sulfonylurea as adjunct therapy with diet for a patient with type 2 diabetes. Which of the following drugs would meet the criteria for this patient

glyburide

second generation sulfonylurea

glyburide

prototype sulfonylureas

glyburide glynase

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."

The nurse is teaching a patient newly diagnosed with type 2 diabetes mellitus about diet. Which of the following statements indicates an understanding of this education?

"Less than 30% of my daily calories should come from fat."

A client with type 1 diabetes has been prescribed 12 units of regular insulin and 34 units of NPH insulin in the morning. How should the nurse explain why two different types of insulin are required to control the client's blood glucose?

"The different onsets and peaks of the two types provide better overall glucose control.

A 23-year-old patient is diagnosed with type 2 diabetes mellitus. Which of the following statements, by the patient, indicates an understanding of this diagnosis?

"Weight loss could eliminate the need for me to take medications."

rapid acting insulins

- Lispro - aspart - glulisine

long acting insulin

- glargine - detemir

may be used instead of regular subcutaneous insulin

- lispro - aspart - glulisine

metformin is a

Biguanide

A patient is receiving insulin aspart subcutaneously to manage blood glucose levels. What is the time to onset of this type of insulin?

10-20 minutes

levels of what indicate control of diabetes

6.5-7

alpha glucosidase inhibitor prototype

Acarbose (Precose)

Angiotensin-converting enzyme (ACE) inhibitors

Enalapril (Vasotec)

noninsulin injectable antidiabetic drug

Exenatide pramlintide

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

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

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

A client has been prescribed acarbose. What is the advantage of acarbose over alternative drugs?

It delays the digestion of complex carbohydrates.

A patient has been diagnosed with diabetes mellitus. Which of the following statements is true regarding this condition?

It is estimated that 28.7 million people in the United States are diagnosed with diabetes. , How the body responds to food is an important indicator of a patient's risk for diabetes., Diabetes can cause atherosclerotic plaques in vessels, leading to heart attack or stroke.

What is the expected action of sitagliptin on type 2 diabetes?

It slows the rate of inactivation of the incretin hormones.

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 nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode?

Orange or other fruit juice Glucose tablets hard candy

amylin analogs

Pramlintide (Symlin)

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.

meglitinides prototype

Repaglinide (Prandin)

thiazolidinediones prototype

Rosiglitazone (Avandia)

oral antidiabetic

Sitagliptin glipizide pioglitazone

glyburide is a

Sulfonylurea

A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction?

Take an oral dose of some form of glucose as soon as possible.

A patient with no medical history of diabetes is seen in the emergency room after an automobile accident. The patient's blood glucose is 305 mg/dL. Which of the following statements best describes the most plausible reason for the elevated blood glucose?

The accident stimulated the body's fight or flight responses.

A patient's blood glucose is 36 mg/dL. Which of the following signs and symptoms are associated with this level of blood glucose?

Weakness, Headache, Confusion, Diaphoresis

A patient diagnosed with type 2 diabetes mellitus is requesting information on increasing exercise to help manage blood glucose levels. Which of the following information would be appropriate to give the patient?

You should set a goal of participating in 150 minutes of structured exercise per week.

after subcutaneous injection insulin is absorbed most rapidly from

abdomen

hyperglycemia level

above 126

inhaled regular insulin analog

afrezza

The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?

allergy to sulfonamides

The following patients are prescribed metformin. Which patient is likely at the greatest risk of having an adverse reaction to metformin?

an alcoholic

Which of the following would the nurse recognize as associated with type 1 diabetes mellitus?

beta cells are destroyed

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

between 8:30 and 9:30

hypoglycemia level

blood glucose less than 40

sodium glucose contransporter 2 inhibitors

canagliflozin

A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?

deep respirations

Glucagon-like peptide 1 (GLP-1)

exenatide

The nurse is providing education to the parents of a child who has been newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching?

exogenous insulin is required for life

The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb?

garlic

glipizide Is used to treat

hyperglycemia

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?

increases insulin release

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?

increases insulin release decrease glucagon release slow gi emptying stimulate satiety center

Insulin is a hormone released by the pancreatic beta cells in response to a rise in glucose levels and what else?

incretins

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse likely administer?

insulin lispro

drug often used for long term insulin therapy

isophane insulin NPH

an A1c level should be

less than 7

Rosiglitazone is being considered for the treatment of diabetes in an adult client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn?

liver enzymes

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

massaging the site

biguanide drug

metformin

glyburide is normally taken when

morning

Which are risk factors for type-2 diabetes that a nurse should recognize in a client?

obesity history of gestational diabetes impaired glucose tolerance

A patient with type 2 diabetes mellitus is fatigued and complaining of thirst. Which of the following interventions, ordered by the healthcare provider, should be implemented first for this patient?

obtain a blood glucose level

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

The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give?

regular

When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?

regular

insulin of choice during acute situations

regular insulin (insulin injection)

symptoms of hypoglycemia

shakiness, dizziness or light-headedness, sweating, nervousness or irritability, sudden changes in behavior or mood, weakness, pale skin, and hunger

A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse likely administer?

short acting insulin

A client with hypertension is diagnosed with type 2 diabetes. For which reason would the nurse closely monitor the client when giving glyburide with metoprolol?

signs of hypoglycemia may be masked

Dipeptidyl Peptidase-4 Inhibitors

sitagliptin

A client diagnosed with type 2 diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?

slows gastric emptying

oldest and largest group of oral agents used in patients with type 2 diabetes

sulfonylureas

A client with hyperinsulinism has been prescribed diazoxide. After administration, which adverse reaction should the nurse prioritize?

tachycardia

A client diagnosed with type 2 diabetes several months ago has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance?

the client frequently checks blood glucose levels

afrezza is contraindicated in

those with - ASTHMA - COPD

first generation sulfonylurea

tolazamide

insulin is only effective drug for

type 1 diabetes


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