Drug Therapy for DM
A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?
Glucagon
A nurse is preparing to administer a long-acting insulin to a client. Which insulin might the nurse administer? Select all that apply.
Insulin glargine; Insulin detemir
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? a. "I'll keep in mind that glyburide can possibly cause me to have low blood sugar." b. "I'll make sure to check with my provider before I start taking any other medications." c. "I'll plan to take my glyburide each night before I go to bed." d. "I know that glyburide won't cure my diabetes, but it will help me have safe blood sugar levels."
"I'll plan to take my glyburide each night before I go to bed." Explanation: 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.
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."
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."
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? a. 06:00 b. 06:20 c. 06:45 d. 07:00
06:45 Explanation: With short-acting insulins like lispro, aspart, or glulisine, it is important to inject the medication about 15 minutes before eating.
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? a. 0815 b. 0830 c. 0900 d. 1000
0900 Explanation: 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.
The nurse is discussing diabetes mellitus with a group of people who are involved in a weight loss program. The nurse relates to the group that the parameters for a diagnosis of diabetes are a fasting plasma glucose test (FPG) greater than or equal to what level on two separate occasions?
126 mg/dL
A client with diabetes becomes unconscious with a blood sugar of 40 mg/dL and the nurse administers glucagon IV in two doses over 20 minutes without elevation of glucose levels. What is the priority action by the nurse?
Administer IV glucose 50% to the client
A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?
Avoid mixing glargine with other insulin.
The nurse is teaching a class to parents of children who have just been diagnosed with type 1 diabetes mellitus. The nurse informs the parents that recognition of hypoglycemia may be delayed in children because signs and symptoms are vague and the children may be unable to communicate them to parents or caregivers. Because of these difficulties, most pediatric diabetologists recommend maintaining blood glucose levels in what range? a. Between 90 and 110 mg/dL b. Between 110 and 200 mg/dL c. Between 120 and 150 mg/dL d. Between 110 and 150 mg/dL
Between 100 and 200 mg/dL Explanation: Recognition of hypoglycemia may be delayed because signs and symptoms are vague and the children may be unable to communicate them to parents or caregivers. Because of these difficulties, most pediatric diabetologists recommend maintaining blood glucose levels between 100 and 200 mg/dL to prevent hypoglycemia. In addition, the bedtime snack and blood glucose measurement should never be skipped.
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 AM and 9:30 AM
A nurse is caring for a 48-year-old woman who has been hospitalized after injecting the wrong type of insulin. Which sign of hypoglycemia will the nurse be careful to observe for?
Blurred vision
A nurse should take what steps prior to administering insulin glargine (Lantus) to a client? Select all that apply.
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 preparing to administer insulin glargine to a client. Which actions will the nurse perform when preparing the insulin? Select all that apply. a. check the expiration date on the vial b. shake the vial vigorously c. check the health care provider's orders for the type and dosage of insulin d. remove all air bubbles from the syringe barrel e. 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. Explanation: Prior to administering insulin glargine to a client, the nurse must complete the following preadministration steps: carefully check the health care provider's order for the type and dosage of insulin, check the expiration date on the vial, gently rotate the vial between the palms of the hands, gently tilt end to end before withdrawing the insulin, and remove all air bubbles from the syringe barrel. The nurse should never mix or dilute insulin glargine with any other insulin or solution because the insulin will not be effective.
As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?
Delayed growth and development
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.
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.
Which is the best indicator of overall diabetic control?
Glycosylated hemoglobin levels
The nurse has assessed the blood glucose levels of a client with long-standing type 1 diabetes and will administer 8 units of regular insulin, per the client's sliding scale. Which action will the nurse perform?
Have a colleague verify the dose that the nurse has drawn up for administration.
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? a. HbA1c b. stat urine for glucose c. fasting blood glucose in the AM d. insulin level
HbA1c Explanation: 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.
A client with type 1 diabetes is prescribed pramlintide. Which action(s) would the nurse take when giving the client this medication? Select all that apply. a. validate the client is experience gastroparesis b. increase frequency of monitoring blood glucose levels c. mix the medication with insulin to give in one injection d. inject the medication 20 minutes before each major meal e. select a site that is 2 inches away from an insulin injection site
Increase frequency of monitoring blood glucose levels; Inject the medication 20 minutes before each major meal; Select a site that is 2 inches away from an insulin injection site. Explanation: Pramlintide is a human amylin that is used as an adjunct for clients with type 1 or type 2 diabetes. This medication works to modulate gastric emptying after a meal and cause a feeling of fullness or satiety. This medication has a boxed warning about the risk of hypoglycemia when taking this medication. Because of this, blood glucose levels should be closely monitored because the insulin dose may need to be lowered. The medication is delivered through a subcutaneous injection 20 minutes before each major meal. It should be injected into a site that is at least 2 inches away from an insulin injection site. Because this medication slows gastric emptying, it is contraindicated in clients diagnosed with gastroparesis. The medication is not to be mixed with insulin in one syringe for a single injection.
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?
Increases insulin release
When administering insulin, what would be most appropriate? a. shake the vial vigorously to ensure thorough mixing before drawing up the dose b. firmly spread the skin of the area of the intended site of injection c. insert the needle at a 45-degree angle for injection d. massage the injection site firmly after removing the needle and syringe
Insert the needle at a 45-degree angle for injection. Explanation: The vial should be gently rotated and vigorous shaking is to be avoided to ensure uniform suspension of the insulin. Typically the area is pinched to allow access to the loose connective tissue layer. The needle is inserted at a 45-degree angle for subcutaneous administration. Gentle pressure should be applied at the injection site.
A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose?
Inspect the previous injection site for inflammation.
After teaching an in-service presentation to a group of nurses about diabetes and insulin, the presenter determines that the session was successful when the group correctly chooses which insulins as rapid-acting? Select all that apply.
Insulin aspart; Insulin glulisine
A client with diabetes has had a myocardial infarction. Which medication that the client takes on a regular basis should be discontinued and replaced with another diabetic medication?
Metformin
After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide? a. Metformin b. Miglitol c. Tolbutamide d. Glipizide
Metformin Explanation: Metformin is classified as a biguanide. Miglitol is an alpha-glucosidase inhibitor. Tolbutamide is a first generation sulfonylurea. Glipizide is a second generation sulfonylurea.
A client has refused a scheduled dose of metformin, stating that he/she is worried about inducing hypoglycemia because his/her blood glucose level is currently 66 mg/dL (3.66 mmol/L). The nurse should convey what teaching points to the client?
Metformin does not cause hypoglycemia.
After teaching a group of nursing students about antidiabetic drugs, the instructor determines that the teaching was successful when the students correctly choose which drugs as producing the glucose-lowering effects by delaying the digestion and absorption of carbohydrates in the intestine? Select all that apply. a. Glimepiride b. Metformin c. Pioglitazone d. Miglitol e. Acarbose
Miglitol; Acarbose Explanation: The alpha-glucosidase inhibitors, acarbose and miglitol, produce their glucose-lowering effects by delaying the digestion and absorption of carbohydrates in the intestine. Glimepiride is a sulfonylurea. Metformin sensitizes the liver to circulating insulin levels and reduces hepatic glucose production. Pioglitazone decreases insulin resistance and increases insulin sensitivity by modifying several processes, resulting in decreased hepatic glucogenesis (formation of glucose from glycogen) and increased insulin-dependent muscle glucose uptake.
A client diagnosed with type 2 diabetes has been prescribed a meglitinide. The nurse should inform the client that the medication should be taken at what time relative to meals?
No more than 30 minutes before the meal
A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which ongoing assessments should the nurse prioritize when caring for this client? a. assess the skin for ulcers, cuts, and sores b. observe the client for hypoglycemic episodes c. monitor the client for lipodystrophy d. document familial medical history
Observe the client for hypoglycemic episodes. Explanation: As the ongoing assessment activity, the nurse should observe the client for hypoglycemic episodes. Documenting family medical history and assessing the client's skin for ulcers, cuts, and sores should be completed before administering the drug. Lipodystrophy occurs if the sites of insulin injection are not rotated.
A client is prescribed sitagliptin. The nurse would expect to administer this drug by which route?
Oral
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 4-year-old female child is diabetic with a blood glucose level of 120 mg/dL. The child's mother brings her to the health care provider's office with symptoms of the flu and dehydration. What would the nurse expect the provider to order?
Regular sodas, clear juices, and regular gelatin desserts
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.
A nurse is preparing an in-service presentation for a group of staff members on diabetes. Which would the nurse include as the primary delivery system for insulin? a. jet injector b. insulin pen c. external pump d. subcutaneous injection
Subcutaneous injection Explanation: Although other delivery systems are available for insulin administration such as the jet injector, insulin pen, and external pump, subcutaneous injection remains the primary delivery system.
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.
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?
The client frequently checks blood glucose levels.
The nurse is conducting a class for newly diagnosed adult diabetic patients. What would the nurse educate the patients about? a. nutritional understanding b. preservation of intact skin c. the disease d. self-care
The disease Explanation: While it would be important to teach the patients about nutrition, the preservation of intact skin and self-care, adults need extensive education about the disease as well as the drug therapy. Warning signs and symptoms should be stressed repeatedly as the adult learns to juggle insulin needs with exercise, stressors, other drug effects, and diet.
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? a. U-50 (50 units/mL) insulin b. U-20 (20 units/mL) insulin c. U-30 (30 units/mL) insulin d. U-10 (10 units/mL) insulin
U-10 (10 units/mL) insulin Explanation: Administration of insulin for infants and toddlers who weigh less than 10 kg or require less than 5 units of insulin per day can be difficult because small doses are hard to measure in a U-100 syringe. Use of diluted insulin allows more accurate administration. The most common dilution strength is U-10 (10 units/mL), and a diluent is available from insulin manufacturers for this purpose. Vials of diluted insulin should be clearly labeled and should be discarded after 1 month.
A nurse is caring for a client receiving metformin drug therapy to improve glycemic control. What adverse reaction to the drug should the nurse monitor the client for?
asthenia
The nurse is caring for a client who is taking glyburide as treatment for type 2 diabetes mellitus. The health care provider has added a corticosteroid to this client's medication regimen for treatment of a severe allergic reaction. The nurse knows that this drug combination may cause what adverse effect on this client? a. hypoglycemia b. hyperglycemia c. nausea and vomiting d. rash and fever
hyperglycemia Explanation: Corticosteroids increase insulin needs, so the client may develop hyperglycemia.
When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat: a. hypokalemia b. hyperkalemia c. hypoglycemia d. hyperglycemia
hyperglycemia. Explanation: Glipizide is an antidiabetic agent with the desired action of lowering the blood glucose level. It is used to treat hyperglycemia. It would worsen, not treat, hypoglycemia, and it has no role in treating abnormal potassium levels (hypokalemia or hyperkalemia).
The health care provider prescribes glyburide for a client who is a newly diagnosed type 2 diabetic. The nurse knows that this medication produces hypoglycemia by: a. stopping the production of insulin in the liver b. increasing the use of insulin by the muscles c. preventing glucose absorption from the stomach d. increasing insulin secretion from the pancreas
increasing insulin secretion from the pancreas. Explanation: The hypoglycemic action of glyburide results from the stimulation of pancreatic beta cells, leading to increased insulin secretion.
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse likely administer? a. insulin lispro b. insulin glargine c. insulin detemir d. isophane insulin suspension
insulin lispro Explanation: Insulin lispro is an example of a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulin. Isophane insulin suspension is an intermediate-acting insulin.
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? a. liver enzymes b. platelet count c. d-dimer d. creatinine
liver enzymes Explanation: Rosiglitazone has been associated with hepatotoxicity and requires monitoring of liver enzymes. Liver function tests (e.g., serum aminotransferase enzymes) should be checked before starting therapy and every 2 months for 1 year, then periodically. Platelets, d-dimer, and tests of renal function are less significant to the safety and efficacy of treatment.
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously? a. regular b. isophane insulin (NPH) c. lispro d. insulin glargine
regular Explanation: 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 client with diabetes is undergoing testing for glycosylated hemoglobin. The nurse instructs the client that this test measures average blood glucose over what time period? a. the past 3 or 4 months b. the past 7 to 10 days c. the past 1 or 2 months d. the past 12 to 24 hours
the past 3 or 4 months Explanation: Glycosylated hemoglobin measures glucose control over the past 3 to 4 months. When blood glucose levels are high, glucose molecules attach to hemoglobin in the red blood cell. The longer the hyperglycemia lasts, the more glucose binds to the red blood cell and the higher the glycosylated hemoglobin. This binding lasts for the life of the red blood cell (about 4 months) so the other time frames would not be accurate.
The nurse educator works at the diabetes clinic. When talking to a class of adolescent diabetics, the educator tells the students that the most recognized signs of diabetes are:
hyperglycemia and glycosuria.
A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?
"I am on the middle school track team."
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? a. "insulin is used to move carbohydrate particles from the gastrointestinal system to the liver" b. "insulin is stimulated by the liver to break down proteins and provide the body with nutrients" c. "insulin assists glucose molecules to enter the cells of muscle and fat tissues" d. "insulin causes fat to be broken down to provide energy for the body"
"Insulin assists glucose molecules to enter the cells of muscle and fat tissues." Explanation: Insulin appears to activate a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. It also stimulates the synthesis of glycogen by the liver, promotes protein synthesis, and helps the body store fat by preventing its breakdown for energy.
After teaching a group of students about the various methods for the delivery of insulin, the instructor determines that the teaching was successful when the students identify which method as most commonly used for administration? a. subcutaneous injection b. insulin pen c. jet injector d. implantable infusion pump
Subcutaneous injection Explanation: Subcutaneous injection currently is the most common method for administering insulin.
A nurse is preparing to administer insulin glargine to a client. What precaution should the nurse take when administering this drug? a. administer glargine via IV route b. avoid mixing glargine with other insulins c. shake the vial vigorously before withdrawing insulin d. be sure the insulin has been refrigerated
Avoid mixing glargine with other insulins. Explanation: 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.
The nurse is preparing to administer a mixture of 12 units regular insulin and 45 units NPH insulin to a client with a blood sugar of 378 mg/dL. After the nurse draws the medication into the syringe, what is the nurse's next action? a. administer the insulin to the client b. check the dosage with another nurse c. check the client's blood sugar again d. ensure a meal tray is available
Check the dosage with another nurse. Explanation: After preparing the syringe with insulin, the nurse should then have the medication and dosage checked by a second nurse to make sure that it is correct. It is not necessary to recheck the client's blood sugar again. It is important to know when the client will be eating again; make sure that it is within the next 30 minutes. However, this is not the nurse's next step. Then the nurse will administer the insulin to the client.
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? a. client is in good glycemic control b. client's average blood glucose is above normal c. client's blood glucose levels are not consistent d. client's blood glucose demonstrates longstanding hypoglycemia
Client's average blood glucose is above normal. Explanation: The American Diabetes Association (ADA) suggests a target A1C of less than 7%. A1C should be measured every 3 to 6 months. An A1C of 9 indicates that the client's average blood glucose is consistently above normal.
The nurse is working with a client with type 1 diabetes. The client's most recent hemoglobin A1C level is 6.6%. What is the nurse's best action?
Commend the client's vigilant blood glucose control.
Which would a nurse identify as an example of a sulfonylurea? a. glyburide b. metformin c. acarbose d. miglitol
Glyburide Explanation: Glyburide is an example of a sulfonylurea. Metformin is classified as a biguanide. Acarbose and miglitol are alpha-glucosidase inhibitors.
A nurse is preparing to administer insulin to the client. Which interventions should the nurse perform before administering each insulin dose? a. inspect the previous injection site for inflammation b. keep prefilled syringes horizontally c. check for symptoms of myalgia or malaise d. mix the insulin with sterile water in the syringe
Inspect the previous injection site for inflammation. Explanation: The nurse should check the previous injection site before administering each insulin dose. The injection sites should be rotated to prevent lipodystrophy. Prefilled syringes should not be kept horizontally; they should be kept in a vertical or oblique position to avoid plugging the needle. The nurse checks for symptoms of myalgia or malaise when administration of metformin leads to lactic acidosis. Insulin should not be mixed with other drugs in the syringe. Some types of insulin may be combined in one syringe, but sterile water is never used.
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? a. The client will be prescribed an extra dose of metformin to address the contrast media effect on the body. b. Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias. c. The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out of the kidneys. d. Insulin will temporarily be substituted for the metformin to address the risk of potential kidney failure.
Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias. Explanation: Metformin should be discontinued at least 48 hours before diagnostic tests are performed with contrast media and should not be resumed for at least 48 hours after the tests are done and tests indicate renal function is normal. None of the other options are required.
The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated; and has a blood glucose of 60 mg/dL. Which emergent treatment would the nurse most likely give? Select all that apply. a. orange or other fruit juice b. glucose tablets c. insulin glargine d. hard candy e. insulin detemir
Orange or other fruit juice; Glucose tablets; Hard candy Explanation: Methods of terminating a hypoglycemic reaction include the administration of one or more of the following: orange or other fruit juice, hard candy or honey, glucose tablets, glucagon, or glucose 10% or 50% IV.
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 client with hyperinsulinism has been prescribed diazoxide. After administration, which adverse reaction should the nurse prioritize? a. myalgia b. tachycardia c. flatulence d. epigastric discomfort
Tachycardia Explanation: The nurse should monitor for tachycardia, congestive heart failure, sodium and fluid retention, hyperglycemia, and glycosuria as the adverse reactions in the client receiving diazoxide drug therapy. Myalgia, fatigue, and headache are the adverse reactions observed in clients undergoing pioglitazone HCl drug therapy. Flatulence is one of the adverse reactions found in clients receiving metformin drug therapy. Epigastric discomfort is one of the adverse reactions observed in clients receiving acetohexamide drugs.
The nurse in the emergency department receives a conscious client following a motor vehicle accident who has no known history of diabetes but whose blood glucose level is 325 mg/dL (18 mmol/L). What rationale does the nurse provide explaining this elevated blood glucose level? a. The client's accident was caused by undiagnosed hyperglycemia. b. The client may have sustained pancreatic trauma. c. The client most likely ate a meal just before the accident. d. The client's stress reaction likely caused an increase in blood sugar.
The client's stress reaction likely caused an increase in blood sugar. Explanation: The stress reaction elevates the blood glucose concentration above the normal range. In severe stress situations, the blood glucose level can be very high (300 to 400 mg/dL). The body uses that energy to fight the insult or flee from the stressor. It would be unlikely for a hyperglycemic episode to cause a change in consciousness that would result in an accident. Eating food does not cause such a large increase in glucose levels. Pancreatic trauma does not normally cause a precipitous increase in blood glucose levels.
Which are risk factors for type-2 diabetes that a nurse should recognize in a client? Select all that apply: a. younger age b. impaired glucose tolerance c. Caucasian race d. obesity e. history of gestational diabetes
impaired glucose tolerance; obesity; history of gestational diabetes Explanation: A nurse should be able to identify all the risk factors for type-2 diabetes in a client. These include: obesity, older age, family history of diabetes, history of gestational diabetes, impaired glucose tolerance, minimal or no physical activity, and race/ethnicity (Black Americans, Hispanic/Latino Americans, Native Americans, and some Asian Americans).
A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action? a. insulin lispro b. isophane (NPH) c. isophane (NPH) d. Humulin R
insulin lispro Explanation: 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.