Pharm: Endocrine

A nurse administers pramlintide at 0800 to a client who has type 1 diabetes mellitus. At which of the following times should the nurse expect the drug to exert its peak action?

0820

A nurse is caring for a client who is taking metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contrast dye increases the client's risk for which of the following conditions?

Acute renal failure Metformin, a biguanide, can interact with iodine-containing contrast dye and cause acute renal failure and lactic acidosis. The nurse should withhold metformin for 48 hr prior to and following the procedure. The nurse should also monitor the client for indications of acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation, and abdominal pain.

A nurse is teaching a client who has a prescription for pramlintide therapy to treat type 1 diabetes mellitus. Which of the following instructions should the nurse include?

Administer pramlintide before meals

A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply.)

Alanine aminotransferase (ALT) LDL

A nurse is teaching a client who has a prescription for glipizide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include?

Avoid drinking alcohol

A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs?

Beta blockers Clients who take both insulin and beta blockers are at risk for failing to promptly recognize the symptoms of hypoglycemia because beta blockers mask symptoms such as tachycardia and tremors. Beta blockers also increase hypoglycemic effects.

A nurse is teaching a client about acarbose therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include?

Eat more iron-rich foods

A nurse is providing teaching to a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the nurse include?

Expect life-long therapy with the drug

Which of the following drugs should a nurse have available for a client who is experiencing insulin toxicity?

Glucagon Glucagon, a hyperglycemic that can be given subcutaneously, IM, or IV, is used to treat severe hypoglycemia from insulin toxicity in clients who are unconscious and for whom IV glucose is not readily available. If the client does not respond to glucagon, the nurse should administer a glucose solution IV.

When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs?

Hydrocortisone Hydrocortisone, a glucocorticoid, provides replacement therapy for acute and chronic adrenocortical insufficiency, such as Addison's disease. Hydrocortisone is identical to cortisol, the primary glucocorticoid the adrenal cortex generates.

A nurse is caring for a client who is taking propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug?

Hypothyroidism

A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take?

Perform a fingerstick blood glucose check

A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug?

Recent myocardial infarction

A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type 2 diabetes mellitus and who also has which of the following?

Renal impairment Sitagliptin, a gliptin, requires cautious use with clients who have renal dysfunction and low creatinine clearance because the kidneys eliminate the drug virtually intact. The provider should prescribe a lower dose for this client or prescribe a different hypoglycemic drug.

A nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type 2 diabetes mellitus. The client asks, "If I skip a meal, what should I do?" Which of the following responses should the nurse make?

Skip the dose

A nurse is educating the parents of a child who has a new diagnosis of Prader-Willi Syndrome (PWS) and has been prescribed somatropin. Which of the following statements by a parent indicates understanding of the teaching?

[] "we will use a different spot for injection each time we give the medication"

A nurse is providing teaching to a client who is about to begin exenatide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? (Select all that apply.)

[] inject the drug subcutaneously [] expect the peak effect in 2 hr [] use the drug as a supplement to an oral hypoglycemic

A nurse is providing teaching to a client about taking fludrocortisone to treat adrenocortical insufficiency. Which of the following instructions should the nurse include? (Select all that apply.)

[] obtain weight measurement daily [] report weakness or palpitations [] have blood pressure checked regularly

A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply.)

[] sore throat [] joint pain [] bradycardia [] rash

A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply.)

[] urine calcium [] blood glucose

A nurse at a provider's office is assessing a client who has been taking hydrocortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the client's dosage?

hypotension

A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect?

lactic acidosis

A nurse is teaching a client about self-administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following?

lipohypertrophy

A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness?

urine output

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings?

weight gain