Chapter 38 - Agents to Control Blood Glucose Levels PrepU

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

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."

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 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.

Which would be least appropriate when administering insulin by subcutaneous injection?

Massaging the site after removing the needle

The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.)

Orange or other fruit juice Glucose tablets Hard candy

Which condition must be met in order for glyburide treatment to be effective?

The client must have functioning pancreatic beta cells.

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

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

delayed growth and development

A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action?

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

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.

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.

Which would a nurse identify as an example of a sulfonylurea?

glyburide

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

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?

increases insulin release

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

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

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 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 instructing a patient in the administration of regular insulin by the subcutaneous route. Which strategy would the nurse suggest if the goal is to promote absorption of the regular insulin?

Select one anatomic area for regular insulin injections and then use serial locations within that area.

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?

06:45

A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.)

Assist the client in making menus that will meet the needs of both the client and the family. Watch the client draw up and administer her insulin. Reinforce instructions on dealing with hypoglycemia.

What is the expected action of sitagliptin on type 2 diabetes?

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?

Lifelong exogenous insulin is required.

The nurse is conducting a class for newly diagnosed adult diabetic patients. What would the nurse educate the patients about?

disease

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?

garlic

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

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?

regular insulin