Glucose/Diabetes2

A nurse is teaching a patient about the drug metformin. Which of the following concepts about therapeutic effects would be appropriate to teach? Select all that apply. A. Metformin decreases hepatic production of glucose. B. Metformin decreases intestinal absorption of glucose. C. Metformin increases insulin sensitivity. D. Metformin increases release of insulin by the pancreas.

A. Metformin decreases hepatic production of glucose. B. Metformin decreases intestinal absorption of glucose. C. Metformin increases insulin sensitivity. Metformin exhibits the effects stated in the first three options, whereas oral sulfonamides increase the release of insulin by the pancreas. Metformin may be used in combination with a sulfonylurea to more effectively control the blood glucose level because they work through different mechanisms.

A patient with type 2 diabetes mellitus has learned about the management of the disease. Which of the following patient statements indicates that the patient has a proper understanding of the information presented? A. "Diabetic pills, diet, and exercise are all important in controlling this disease." B. "I must take oral insulin twice a day." C. "Oral diabetes medicines and weight loss will help me cure the disease." D. "I can eat whatever I want as long as I take my medicine."

A. "Diabetic pills, diet, and exercise are all important in controlling this disease." The cornerstones of treatment for patients with type 2 diabetes are antidiabetic drugs, diet, and exercise. There is no such thing as oral insulin. Oral antidiabetic drugs do not cure diabetes—they control the symptoms. Antidiabetic drugs are not a substitute for diet: rather, they are an adjunct.

When the cause of hypoglycemia is organic and the effects mild, treatment usually consists of which of the following interventions? Select all that apply. A. A higher intake of protein B. A higher intake of concentrated carbohydrates C. A lower intake of carbohydrates D. A reduction in fat intake

A. A higher intake of protein C. A lower intake of carbohydrates A higher intake of protein and a reduction in carbohydrate intake will usually relieve hypoglycemic symptoms as long as they are organic in origin and the effects mild. A higher intake of concentrated carbohydrates will cause a rebound postprandial hypoglycemia. Altering fat intake is not effective in treating hypoglycemia.

Which three factors of those listed below contribute most to the successful treatment for diabetes mellitus, regardless of the modality chosen? Select all that apply. A. Antidiabetic medicines B. Blood sugar readings C. Dietary modifications D. Regular exercise program E. Personal preference

A. Antidiabetic medicines C. Dietary modifications D. Regular exercise program Dietary modifications, a regular exercise program, and correct use of antidiabetic medicines are most likely to contribute to the success of a diabetes treatment program. Although personal preference is a consideration, it is not a primary treatment modality in the treatment of type 2 diabetes. Keeping a record of blood sugar readings is important and does become a consideration in the treatment modality chosen but is not one of the three primary modalities.

Antidiabetic drugs occasionally contribute to episodes of hypoglycemia, regardless of how well educated the patient is about diabetes mellitus. The nurse would teach the patient to watch for which of the following hypoglycemia symptoms? Select all that apply. A. Confusion B. Diaphoresis C. Decreased blood glucose readings on fingerstick D. Irritability E. Polydipsia F. Polyphagia G. Polyuria H. Retinopathy I. Seizures J. Tremors

A. Confusion B. Diaphoresis C. Decreased blood glucose readings on fingerstick D. Irritability I. Seizures J. Tremors Confusion, diaphoresis, decreased blood glucose readings on fingerstick, irritability, seizures, and tremors all suggest the low blood sugar level known as hypoglycemia. The three "Ps"—polydipsia, polyphagia, and polyuria—are symptoms of hyperglycemia and improve with diabetic control. Retinopathy is a long-term complication characterized by changes in retinal blood vessels.

Insulin has which of the following influences on carbohydrate metabolism? A. Decreases glucose oxidation B. Increases cellular uptake of glucose C. Decreases glucose storage D. Increases the rate of gluconeogenesis

B. Increases cellular uptake of glucose Insulin influences carbohydrate metabolism by increasing glucose uptake, increasing glucose oxidation, and increasing glucose storage. It decreases glycogenolysis and gluconeogenesis.

What are the three long-term complications of diabetes mellitus? Select all that apply. A. Diabetic ketoacidosis B. Hyperglycemia C. Nephropathy D. Neuropathy E. Polydipsia F. Polyphagia G. Polyuria H. Retinopathy

C. Nephropathy D. Neuropathy H. Retinopathy Nephropathy, neuropathy, and retinopathy are the three long-term complications of diabetes mellitus. Diabetic ketoacidosis, although serious, is a short-term event. The three "Ps"—polydipsia, polyphagia, and polyuria—are three symptoms of diabetes mellitus and ordinarily improve with diabetic control.

Before beginning drug therapy with a sulfonylurea, the patient should be assessed for allergy to which of the following substances? A. Bovine (beef) insulin B. Porcine (pork) insulin C. Sulfonamide antibiotics D. Penicillin antibiotics

C. Sulfonamide antibiotics Sulfonylurea use should be avoided in patients with a history of severe reaction to a structurally related drug, such as a sulfonamide antibiotic. The other responses are incorrect.