prepU ch 38 Agents to Control Blood Glucose Levels
A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?
It slows gastric emptying.
What is the expected action of sitagliptin on type 2 diabetes?
It slows the rate of inactivation of the incretin hormones.
Which would a nurse identify as an example of a sulfonylurea?
Glyburide
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
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
regular
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?
the past 3 or 4 months
A client newly diagnosed with type 2 diabetes has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching?
"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."
The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?
"If I forget to take my insulin pen, I will be able to use the one that my wife uses."
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 newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching?
"Regular exercise makes your body better able to use the insulin it produces."
A 42-year-old male client is prescribed glargine insulin for management of his type 2 diabetes mellitus. The nurse caring for the client develops a teaching plan regarding glargine insulin therapy. Which statement made by the client indicates that the client needs additional teaching?
"The medication will peak in 3 hours."
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
A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment?
Assess the most recent hemoglobin A1C levels.
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.
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 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?
Client's average blood glucose is above normal.
Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which action does this enable?
Entry of glucose into the cells
The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client?
Hypoglycemia
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.
A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?
Insulin is needed because the beta cells of the pancreas are no longer functioning.
A female client is prescribed metformin to decrease her blood glucose levels associated with diabetes mellitus type 2. Which statement accurately describes the action of metformin?
It decreases intestinal absorption of glucose and improves insulin sensitivity.
Which would be appropriate to include in teaching a client with type 2 diabetes?
It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.
The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?
Lifelong exogenous insulin is required.
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?
Metformin
A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?
Observe the patient for hypoglycemic episodes.
A client diagnosed with diabetic ketoacidosis has been admitted to the intensive care unit. The client is prescribed an intravenous insulin drip, so the nurse knows that what type of insulin will be administered?
Regular
A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response?
Regular (Humulin R)
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?
Subcutaneous injection
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?
Subcutaneous injection
The stress response triggered by illness will result in the increase secretion of what hormone? Select all that apply.
cortisol, glucagon, growth, epinephrine
What would alert the nurse to suspect that a client is developing ketoacidosis?
fruity breath odor
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?
insulin lispro
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
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 insulin