Pharmacology Agents to control blood sugar glucose levels

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." "I don't like getting this diagnosis, but I know that treatment now can prevent future health consequences." People always tried to encourage me to lose weight, and I suppose they might have been right." "From what I've learned, I know that the basic problem is that my pancreas can't keep up with my insulin needs."

"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? "I need to turn the dial on the pen and listen for the locking ring before administering my insulin." "If I forget to take my insulin pen, I will be able to use the one that my wife uses." "I determine my dosage by the number of clicks that I hear." "This will make it easier for me to give my own insulin because of my poor eyesight."

"If I forget to take my insulin pen, I will be able to use the one that my wife uses."

A client has been newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching? "Regular exercise makes your body better able to use the insulin it produces." "Until you need to start insulin injections, you do not have to check your blood sugar."

"Regular exercise makes your body better able to use the insulin it produces."

A client has been newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching? "Until you need to start insulin injections, you do not have to check your blood sugar. "Regular exercise makes your body better able to use the insulin it produces." "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 for you to increase your oral antidiabetic medication."

"Regular exercise makes your body better able to use the insulin it produces."

The nurse transcribes an order for sitagliptin. What is an appropriate dosage range for this medication? 1 to 8 mg/d 100 mg/d

100mg/d

A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? Arrange to have the client's random blood glucose measured. Assess the most recent hemoglobin A1C levels. Dialogue with the client about implemented management strategies. Review and discuss the data contained in the client's written blood glucose log.

Assess the most recent hemoglobin A1C levels.

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

Avoid mixing glargine with other insulin.

A nurse is preparing to administer insulin glargine to a client. What precaution should the nurse take when administering this drug?

Avoid mixing glargine with other insulins.

The diabetes nurse educator describes type 1 diabetes with what statement? Blood glucose level can be controlled with diet. Exogenous insulin is required for life. Oral agents can control blood glucose levels for many clients. It is always diagnosed before adulthood.

Exogenous insulin is required for life.

Which would a nurse identify as an example of a sulfonylurea? Glyburide metformin acarbose miglitol

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 Bradycardia Lipodystrophy Hypotension

Hypoglycemia

Which would be appropriate to include in teaching a client with type 2 diabetes?

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

When administering insulin, what would be most appropriate? Shake the vial vigorously to ensure thorough mixing before drawing up the dose. Insert the needle at a 45-degree angle for injection. Firmly spread the skin of the area of the intended site of injection. Massage the injection site firmly after removing the needle and syringe.

Insert the needle at a 45-degree angle for injection.

A nurse is preparing to administer a long-acting insulin to a client. Which insulin might the nurse administer? Select all that apply. Insulin glargine Insulin detemir Insulin aspart Insulin lispro Insulin glulisine

Insulin glargine Insulin detemir

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

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. Lifelong exogenous insulin is required. Oral agents can control the disease process. It always starts in childhood.

Lifelong exogenous insulin is required.

A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which ongoing assessments should the nurse prioritize when caring for this client?

Observe the client for hypoglycemic episodes.

Which produce their glucose lowering effect by decreasing insulin resistance and increasing insulin sensitivity? (Select all that apply.) Rosiglitazone (Avandia) Metformin (Glucophage) Pioglitazone (Actos) Miglitol (Glyset) Acarbose (Precose)

Rosiglitazone (Avandia) Pioglitazone (Actos)

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

Tachycardia

The nurse is providing education to the parents of a child newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching? Blood glucose levels can be controlled by diet. The child will eventually produce no insulin Oral agents can control blood sugar. The disease always starts in childhood.

The child will eventually produce no insulin

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

A client diagnosed with type 1 diabetes reports recurrent hypoglycemia late in the morning. After collecting the health history, what finding should the nurse suspect is most likely causing the late morning hypoglycemia? The client goes to the gym each day before work. The client eats oatmeal early in the morning for breakfast. The client likes to nap shortly after eating lunch. The client often eats an early lunch, between 11:00 and 11:30.

The client goes to the gym each day before work.

A client in the community is taking regular and NPH insulin to manage type 1 diabetes. What laboratory finding best demonstrates that the client's diabetes management is adequate?

The client's glycosylated hemoglobin (HbA1c) level is 6.1% (0.06).

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

The nurse is preparing to administer insulin glargine to a client. Which actions will the nurse perform when preparing the insulin? Select all that apply. Check the expiration date on the vial. Shake the vial vigorously. Check the health care provider's orders for the type and dosage of insulin. Remove all air bubbles from the syringe barrel. Mix with short-acting insulin prior to administration.

check the expiration date check the health care providers orders for the type and dosage of insulin remove all the air bubbles from the syringe barrel

The nurse suspects the client diagnosed with diabetes may be having a hypoglycemic reaction when what manifestation is assessed? unpredictable behavior's diaphoresis flushing of the face fruity breath

diaphoresis

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 anise basil oregano

garlic

A nurse has determined a client has developed a hypoglycemic reaction. Which interventions should the nurse perform if the client can adequately demonstrate swallowing and gag reflexes? Administer glucagon by the parenteral route give oral fluids or candy

give oral fluid or candy

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

glucagon

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

glyburide

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse likely administer?

insulin lispro

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse likely administer? insulin glargine insulin lispro insulin detemir isophane insulin suspension

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

The nurse is caring for a client who is taking canagliflozin. What is an advantage of this medication?

reduces risk of heart attack or stroke

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.)

head ache confusion diaphoresis

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 aspart insulin glargine

insulin glargine

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 juice or other fruit juice glucose tablets hard candy

A client diagnosed with diabetic ketoacidosis has been admitted to the intensive care unit. The client is prescribed an intravenous insulin drip, so the nurse knows that what type of insulin will be administered? isophane insulin (NPH) lispro regular insulin glargine

regular

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia