Ch 45 Drugs for DM

A 63-year-old patient 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? 1.It is a temporary condition related to the stress response with increased glucose release. 2.He is converting to a type 1 diabetic. 3.The oral antidiabetic drug is no longer working for him. 4.Patients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control.

1.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? 1.Make sure the patient's breakfast is available to eat before administering this insulin. 2.Offer the patient a high-carbohydrate snack in 6 hours. 3.Hold the insulin if the blood glucose level is greater than 100 mg/dL. 4.Administer the medications in two separate syringes.

1.Make sure the patient's 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? (Select all that apply.) 1.Monitor blood glucose levels before and after exercise. 2.Eat a complex carbohydrate prior to strenuous exercise. 3.Exercise may increase insulin needs. 4.Withhold insulin prior to engaging in strenuous exercise. 5.Take extra insulin prior to exercise.

1.Monitor blood glucose levels before and after exercise. 2.Eat a complex carbohydrate prior to strenuous exercise.

The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes. Which of the following statements indicates that the patient needs additional teaching? 1."If I am experiencing hypoglycemia, I should drink 1/2 cup of apple juice." 2."My insulin needs may increase when I have an infection." 3."I must draw the NPH insulin first if I am mixing it with regular insulin." 4."If my blood glucose levels are less than 60 mg/dL, I should notify my health care provider."

3."I must draw the NPH insulin first if I am mixing it with 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 a combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? 1.Hold all medications as per the NPO order. 2.Give him the medications with a sip of water. 3.Give him half the original dose. 4.Contact the health care provider for further orders.

4.Contact the 4.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? 1.The patient needs to plan the next insulin injection around the peak times. 2.Additional insulin may be needed at peak times to avoid hyperglycemia. 3.It is best to plan exercise or other activities around peak insulin activity. 4.The risk for hypoglycemia is greatest around the peak of insulin activity.

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