Pharm Chapter 41 diabetes
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?
give oral fluids or candy
what insulin has the shortest onset
glulisine
A healthcare provider is planning to prescribe a second-generation sulfonylurea as adjunct therapy with diet for a patient with type 2 diabetes. Which of the following drugs would meet the criteria for this patient
glyburide
second generation sulfonylurea
glyburide
prototype sulfonylureas
glyburide glynase
What instructions would be important to give to a 50-year-old client with type 2 diabetes who has been switched from glyburide , a sulfonylurea, to repaglinide, a meglitinide?
"It stimulates insulin production, so you need to eat soon after taking the medication."
The nurse is teaching a patient newly diagnosed with type 2 diabetes mellitus about diet. Which of the following statements indicates an understanding of this education?
"Less than 30% of my daily calories should come from fat."
A client with type 1 diabetes has been prescribed 12 units of regular insulin and 34 units of NPH insulin in the morning. How should the nurse explain why two different types of insulin are required to control the client's blood glucose?
"The different onsets and peaks of the two types provide better overall glucose control.
A 23-year-old patient is diagnosed with type 2 diabetes mellitus. Which of the following statements, by the patient, indicates an understanding of this diagnosis?
"Weight loss could eliminate the need for me to take medications."
rapid acting insulins
- Lispro - aspart - glulisine
long acting insulin
- glargine - detemir
may be used instead of regular subcutaneous insulin
- lispro - aspart - glulisine
metformin is a
Biguanide
A patient is receiving insulin aspart subcutaneously to manage blood glucose levels. What is the time to onset of this type of insulin?
10-20 minutes
levels of what indicate control of diabetes
6.5-7
alpha glucosidase inhibitor prototype
Acarbose (Precose)
Angiotensin-converting enzyme (ACE) inhibitors
Enalapril (Vasotec)
noninsulin injectable antidiabetic drug
Exenatide pramlintide
The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not record glucometer readings. What laboratory test does the nurse anticipate the health care provider will order for this client?
HbA1c
A client is receiving acarbose. What would the nurse incorporate into the teaching plan for this client about the action of the drug?
Inhibits an enzyme to delay glucose absorption
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."
A client has been prescribed acarbose. What is the advantage of acarbose over alternative drugs?
It delays the digestion of complex carbohydrates.
A patient has been diagnosed with diabetes mellitus. Which of the following statements is true regarding this condition?
It is estimated that 28.7 million people in the United States are diagnosed with diabetes. , How the body responds to food is an important indicator of a patient's risk for diabetes., Diabetes can cause atherosclerotic plaques in vessels, leading to heart attack or stroke.
What is the expected action of sitagliptin on type 2 diabetes?
It slows the rate of inactivation of the incretin hormones.
A client who has been prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client?
Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.
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?
Orange or other fruit juice Glucose tablets hard candy
amylin analogs
Pramlintide (Symlin)
The home care nurse is caring for an older adult client who has been diagnosed with type 1 diabetes. The client has visual impairment and cannot read the numbers on the syringe when preparing insulin for administration nor afford the cost of prefilled auto syringes. What strategy might the nurse use to help this client comply with insulin needs between visits?
Prepare a week's supply of syringes and refrigerate.
meglitinides prototype
Repaglinide (Prandin)
thiazolidinediones prototype
Rosiglitazone (Avandia)
oral antidiabetic
Sitagliptin glipizide pioglitazone
glyburide is a
Sulfonylurea
A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction?
Take an oral dose of some form of glucose as soon as possible.
A patient with no medical history of diabetes is seen in the emergency room after an automobile accident. The patient's blood glucose is 305 mg/dL. Which of the following statements best describes the most plausible reason for the elevated blood glucose?
The accident stimulated the body's fight or flight responses.
A patient's blood glucose is 36 mg/dL. Which of the following signs and symptoms are associated with this level of blood glucose?
Weakness, Headache, Confusion, Diaphoresis
A patient diagnosed with type 2 diabetes mellitus is requesting information on increasing exercise to help manage blood glucose levels. Which of the following information would be appropriate to give the patient?
You should set a goal of participating in 150 minutes of structured exercise per week.
after subcutaneous injection insulin is absorbed most rapidly from
abdomen
hyperglycemia level
above 126
inhaled regular insulin analog
afrezza
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 following patients are prescribed metformin. Which patient is likely at the greatest risk of having an adverse reaction to metformin?
an alcoholic
Which of the following would the nurse recognize as associated with type 1 diabetes mellitus?
beta cells are destroyed
A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?
between 8:30 and 9:30
hypoglycemia level
blood glucose less than 40
sodium glucose contransporter 2 inhibitors
canagliflozin
A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?
deep respirations
Glucagon-like peptide 1 (GLP-1)
exenatide
The nurse is providing education to the parents of a child who has been newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching?
exogenous insulin is required for life
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
glipizide Is used to treat
hyperglycemia
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?
increases insulin release
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?
increases insulin release decrease glucagon release slow gi emptying stimulate satiety center
Insulin is a hormone released by the pancreatic beta cells in response to a rise in glucose levels and what else?
incretins
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse likely administer?
insulin lispro
drug often used for long term insulin therapy
isophane insulin NPH
an A1c level should be
less than 7
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
Which would be least appropriate when administering insulin by subcutaneous injection?
massaging the site
biguanide drug
metformin
glyburide is normally taken when
morning
Which are risk factors for type-2 diabetes that a nurse should recognize in a client?
obesity history of gestational diabetes impaired glucose tolerance
A patient with type 2 diabetes mellitus is fatigued and complaining of thirst. Which of the following interventions, ordered by the healthcare provider, should be implemented first for this patient?
obtain a blood glucose level
A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?
perform a blood sugar analysis
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
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
regular
insulin of choice during acute situations
regular insulin (insulin injection)
symptoms of hypoglycemia
shakiness, dizziness or light-headedness, sweating, nervousness or irritability, sudden changes in behavior or mood, weakness, pale skin, and hunger
A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse likely administer?
short acting 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?
signs of hypoglycemia may be masked
Dipeptidyl Peptidase-4 Inhibitors
sitagliptin
A client diagnosed with type 2 diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?
slows gastric emptying
oldest and largest group of oral agents used in patients with type 2 diabetes
sulfonylureas
A client with hyperinsulinism has been prescribed diazoxide. After administration, which adverse reaction should the nurse prioritize?
tachycardia
A client diagnosed with type 2 diabetes several months ago has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance?
the client frequently checks blood glucose levels
afrezza is contraindicated in
those with - ASTHMA - COPD
first generation sulfonylurea
tolazamide
insulin is only effective drug for
type 1 diabetes