Chapter 38: Agents to Control Blood Glucose Levels

A client with type 1 diabetes has been prescribed insulin glargine for the first time. What will the nurse teach the client about this medication? "It will be important to time administration carefully around your meal schedule." "This insulin will provide a steady amount of insulin over 24 hours." "It's important to eat at least every 2 hours while taking insulin glargine." "If successful, this will eliminate your need to take other forms of insulin."

"This insulin will provide a steady amount of insulin over 24 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? A diagnosis of hypertension Allergy to sulfonamides Increase in alkaline phosphatase The ingestion of carbohydrates

Allergy to sulfonamides

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. Administer insulin that has been refrigerated. Shake the vial vigorously before withdrawing insulin. Administer glargine via IV route.

Avoid mixing glargine with other insulin

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration? Do not give pramlintide in the same site where insulin is administered. Mix pramlintide in the same syringe with insulin. Inject pramlintide in the same site where insulin is administered. Pramlintide should only be injected in the hip.

Do not give pramlintide in the same site where insulin is administered.

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 Release of glucagon from the cells Interruption of glucose movement across the membrane Storage of glucagon in the cells

Entry of glucose into the cells

A client with hyperinsulinism has been prescribed diazoxide. After administration, which adverse reaction should the nurse prioritize? Flatulence Tachycardia Epigastric discomfort Myalgia

Flatulence Tachycardia

The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb? Basil Anise Garlic Oregano

Garlic

The nurse is assessing a client for risk factors associated with type 2 diabetes. Which findings would the nurse prioritize? Select all that apply. History of gestational diabetes Obesity Caucasian race Younger age Impaired glucose tolerance

History of gestational diabetes Obesity Impaired glucose tolerance

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include? Increases GI emptying Increases insulin release Increases protein building Increases glucagon release

Increases insulin release

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. The client most likely does not exercise enough to control his glucose levels. More insulin is needed than that which the client can produce naturally. The insulin is more effective in establishing control of blood glucose levels initially.

Insulin is needed because the beta cells of the pancreas are no longer functioning.

Which would be appropriate to include in teaching a client with type 2 diabetes? Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines. If you drink alcohol, it may be necessary to increase your oral antidiabetic medication. It is possible with weight loss and exercise to discontinue the use of antidiabetic medication. Until you need to start insulin injections, you do not have to check your blood sugar.

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

What is the expected action of sitagliptin on type 2 diabetes? It inhibits hydrogen, potassium, and ATPase. It blocks the S phase of the cell cycle. It is a synthetically prepared monosodium salt. It slows the rate of inactivation of the incretin hormones.

It slows the rate of inactivation of the incretin hormones.

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes? Blood glucose level can be controlled with diet. It always starts in childhood. Lifelong exogenous insulin is required. Oral agents can control the disease process.

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? Miglitol Metformin Glipizide Tolbutamide

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. Document family medical history. Monitor the patient for lipodystrophy. Assess the skin for ulcers, cuts, and sores.

Observe the patient for hypoglycemic episodes.

A client is prescribed sitagliptin. The nurse would expect to administer this drug by which route? Intravenous Intramuscular Subcutaneous Oral

Oral

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? Lente insulin NPH insulin Ultralente insulin Regular insulin

Regular insulin

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? Blood glucose levels will increase. Blood pressure will increase. Orthostatic hypotension can develop. Signs of hypoglycemia may be masked.

Signs of hypoglycemia may be masked.

The nurse is conducting a class for newly diagnosed adult diabetic patients. What would the nurse educate the patients about? Self-care The disease Preservation of intact skin Nutritional understanding

The disease

As the first-line treatment, a client with type 2 diabetes has tried diet and exercise. When these fail, what may be added as monotherapy or in combination with metformin to control their disease process? A sitagliptin Repaglinide An incretin agent Thiazolidinediones

Thiazolidinediones

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin? insulin glargine insulin lispro insulin aspart isophane insulin suspension

insulin glargine

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? creatinine d-dimer liver enzymes platelet count

liver enzymes

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 the past 1 or 2 months the past 12 to 24 hours the past 7 to 10 days

the past 3 or 4 months

The nurse is caring for a client who is taking a thiazide diuretic, a corticosteroid, and estrogens. The nurse understands that this client is at risk for what condition? Congestive heart failure Hypoglycemia Pulmonary hypertension Hyperglycemia

Hyperglycemia

The nurse is administering the intermediate-acting insulin preparation, isophane suspension. What does the nurse identify will slow the absorption and prolong the duration of action? Amino acids that have been added to the suspension Glucose hormone that is modified as a buffer Zinc crystals that have been modified by protamine in a neural buffer Potassium that is added to the suspension

Zinc crystals that have been modified by protamine in a neural buffer