Ch. 45 Drugs for Diabetes

The nurse is initiating client education about the medication Glucophage (metformin). Which question is most important to ask the client before beginning therapy on metformin? a. "Do you have any known liver function abnormalities?" b. "Are you able to limit your fluid intake to avoid bloating?" c. "Do you have a way to crush your pills before mixing them with food?" d. "Will you have difficulty eating only three main meals per day?"

a. "Do you have any known liver function abnormalities?"

Which information should the nurse give to the diabetic client who is starting on glargine (Lantus)? a. Do not mix this medication with any other insulin. b. Eat a complex carbohydrate within 15 minutes of administration. c. Stress and illness does not require an increase in dosing needs. d. Withhold the dose if evening blood sugar is less than 200 mg/dL.

a. Do not mix this medication with any other insulin.

The client is scheduled to receive 5 units of Humalog and 25 units of glargine (Lantus) insulin prior to bedtime for a blood sugar of 252. Which nursing intervention is most appropriate for this client? a. Make sure the client eats a snack before going to sleep. b. Offer the client a high-carbohydrate snack at 6 a.m. c. Do not administer the glargine (Lantus) insulin. d. Administer the medications together in one syringe.

a. Make sure the client eats a snack before going to sleep.

Which information should the nurse give to the client who has diabetes managed with insulin and who is planning to engage in an exercise program? a. Monitor blood glucose levels before and after exercise. b. Eat a complex carbohydrate at the first sign of hypoglycemia. c. Exercise will not necessitate changes in insulin needs. d. Withhold insulin before engaging in strenuous exercise.

a. Monitor blood glucose levels before and after exercise.

The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes. Which of the following statements indicates that the patient needs addition teaching? a. "if I am experiencing hypoglycemia I should drink 1/2 cup of apple juice" b. "my insulin needs may increase when I have an infection" c. "I must draw the NPH insulin first if I am mixing it with regular insulin" d. "if my blood glucose levels are less than 60 mg/dL I should notify my health care provider"

c. "I must draw the NPH insulin first if I am mixing it with regular insulin"

A 63-year-old with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control on glyburide (Micronase), his blood glucose has been elevated the past several days and he requires sliding-scale insulin. what is the most likely reason for the elevated glucose levels? a. it is a temporary condition related to the stress response with increased glucose release b. he is concreting to a type 1 diabetic c. the oral anti diabetic drug is no longer working for him d. patients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control

a. it is a temporary condition related to the stress response with increased glucose release

The patient is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this patient? a. make sure the patient breakfast is available to eat before administering this insulin b. offer the patient a high-carbohydrate snack in 6 hours c. hold the insulin if the blood glucose level is greater than 100 mg/dL d. administer the medications in two separate syringes

a. make sure the patient breakfast is available to eat before administering this insulin

What patient education should the nurse provide to the patient with diabetes who is planning an exercise program? (SATA) a. monitor blood glucose levels before and after exercise b. eat a complex carbohydrate prior to strenuous exercise c. exercise may increase insulin needs d. withhold insulin prior to engaging in strenuous exercise e. take extra insulin prior to exercise

a. monitor blood glucose levels before and after exercise b. eat a complex carbohydrate prior to strenuous exercise

A client with type 2 diabetes is prescribed to take glyburide 10 mg by mouth daily. The client asks the nurse when would be the best time to take this medication. What is the nurse's best response? a. "Take the medication in the evening, with a snack." b. "Take the medication in the morning, 30 minutes before breakfast." c. "This medication should be taken after the midday meal." d. "It does not matter what time of day you take this medication."

b. "Take the medication in the morning, 30 minutes before breakfast."

Which information should the nurse emphasize with the client when teaching about the medication administration of glipizide (Glucotrol)? a. The drug can decrease absorption of folate. b. The drug should not be taken with alcohol. c. The drug must be taken with evening meals. d. The drug can affect renal and liver functions.

b. The drug should not be taken with alcohol.

A nurse is initiating discharge teaching with a newly diagnosed diabetic. Which statement indicates that the client needs additional teaching? a. "If I am experiencing hypoglycemia, I should drink half a cup of apple juice." b. "My insulin needs might increase when I have an infection." c. "I must draw the NPH insulin first, if I am mixing it with regular insulin." d. "For blood sugar levels of 300 mg/dL or higher, I must check my urine for ketones."

c. "I must draw the NPH insulin first, if I am mixing it with regular insulin."

A nurse administers regular insulin 4 units to a client with a blood sugar of 228 mg/dL. For which symptoms of hypoglycemia should the nurse monitor in the client? a. Hypothermia and seizures b. Nausea and diarrhea c. Irritability and confusion d. Fruity, acetone odor to the breath

c. Irritability and confusion

The client received NPH (isophane) insulin at 0730. Based on an understanding of peak time, the nurse should assess the client for hypoglycemia at which time? a. 1000 b. 1200 c. 1400 d. 1600

d. 1600

The client is newly admitted with clinical manifestations of type 1 diabetes ketoacidosis. Which medication should the nurse anticipate administering immediately to this client via intravenous access? a. Glucagon b. Pancreatin (Viokase) c. Glargine (Lantus) d. Regular insulin

d. Regular insulin

A patient with type 2 diabetes has been nothing by mouth (NPO) since midnight for surgery in the morning. He has been on combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? a. hold all medications per the NPO order b. give him the medications with a sip of water c. give him half the original dose d. contact the health care provider for further orders

d. contact the health care provider for further orders

A patient receives NPH and regular insulin every morning. the nurse is verifying that the patient understands that there are two different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress? a. the patient needs to plan the next insulin injection around the peak times b. additional insulin may be needed at peak times to avoid hyperglycemia c. it is best to plan exercise or other activities around peak insulin activity d. the risk for hypoglycemia is greatest around the peak of insulin activity

d. the risk for hypoglycemia is greatest around the peak of insulin activity