Pharmacology: Chapter 57: Drugs for Diabetes Mellitus

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe?

"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."

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."

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?

"Inject this insulin with your first bite of food, becuase it is very fast acting."

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"

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient?

Altered fat metabolism leading to ketones; Sudden onset, triggered by acute illness; Plasma osmolality of 300 to 320 mOsm/L

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 patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication?

Blood glucose control for 24 hours

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

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take?

Check the patient's capillary blood sugar

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 newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body?

It promotes the passage of glucose into cells for energy

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 statment 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 who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect?

Promotion of insulin secretion

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan?

Refer the patient to a diabetes educator because the result reflects poor glycemic control

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 nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse?

Sweating

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom?

Tachycardia

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

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 newly diagnosed with diabetes expresses concern about losing her vision. Which interventions should be included in the plan of care to reduce this risk?

Ways to reduce hyperglycemia episodes; Smoking cessation; Emphasis on the importance of taking antihypertensive drugs consistently

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."

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?

Creatinine (Cr) level of 2.1 mg/dL