Chapter 57: Drugs for diabetes mellitus
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include?
Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis
What is the most reliable measure for assessing diabetes control over the preceding 3-month period?
Glycosylated hemoglobin level
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?
Lispro [Humalog]
Which statement is correct about the contrast between acarbose and miglitol?
Miglitol has not been associated with hepatic dysfunction.
Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?
Once daily at bedtime
Which statement is accurate about the long-term complications of diabetes?
Optimal control of both types of diabetes reduces the risk of eye, kidney, and nerve damage.
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule?
Six or seven times a day
A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?
The beta blocker can mask the symptoms of hypoglycemia.
A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient?
This is an acceptable practice.
A patient who has type 2 diabetes will begin taking glipizide [Glucotrol]. Which statement by the patient is concerning to the nurse?
"I may continue to have a glass of wine with dinner."
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response?
"Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included?
"You should use a carbohydrate counting approach to maintain glycemic control."
An elderly patient who has type 2 diabetes has a history of severe hypoglycemia. The patient's spouse asks the nurse what the optimum A1c level is for the patient. Which is correct?
Below 8.0
A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's understanding, the nurse asks, "Which sign or symptom would not be consistent with ketoacidosis?" The group gives which correct answer?
Blood glucose level of 60 mg/dL
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?
The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin