Pharmacology II Chpt. 38 Agents to Control Blood Glucose 5-8

Accumulation and hypoglycemia

54-year-old male client is diagnosed with chronic renal failure and hyperglycemia. He asks if he can be prescribed sulfonylurea because it works well for his friend. If he were to be given sulfonylurea, this client's renal impairment may lead to what effect? Accumulation and hyperglycemic reactions Decreased absorption of the sulfonylurea Accumulation and hypoglycemia Hypersensitivity to sulfonylurea

Deep respirations

A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess? Deep respirations Edema Decreased blood glucose levels Sour breath odor

Inhibits an enzyme to delay glucose absorption

A client is receiving acarbose. What would the nurse incorporate into the teaching plan for this client about the action of the drug? Decreases insulin resistance Inhibits an enzyme to delay glucose absorption Binds to potassium channels on pancreatic beta cells Increases the uptake of glucose

Between 10:00 AM and 12:00 PM

A client receives regular insulin at 8:00 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time? Between 8:30 AM and 9:30 AM Between 2:00 PM and 4:00 PM Between 10:00 AM and 12:00 PM Between 12:00 PM and 8:00 PM

"A fasting blood sugar result of 126 mg/dL (6.99 mmol/L) or more on two separate occasions is diagnostic of diabetes."

A client, being evaluated for diabetes, asks how a blood glucose test is used to diagnosis this disease. What is the nurse's best response? "A fasting blood sugar result of 126 mg/dL (6.99 mmol/L) or more on two separate occasions is diagnostic of diabetes." "A fasting blood sugar result of 100 mg/dL (5.55 mmol/L) or more on two separate occasions is diagnostic of diabetes." "A fasting blood sugar result of 100 mg/dL (5.55 mmol/L) or more and an A1C of more than 6 on two separate occasions are diagnostic of diabetes." "Two consecutive glycosylated hemoglobin (hemoglobin A1C) results of 6 or more are diagnostic of diabetes."

It decreases intestinal absorption of glucose and improves insulin sensitivity.

A female client is prescribed metformin to decrease her blood glucose levels associated with diabetes mellitus type 2. Which statement accurately describes the action of metformin? It stimulates insulin release from the beta cells of the pancreas. It increases intestinal absorption of glucose and improves insulin sensitivity. It decreases intestinal absorption of glucose and improves insulin sensitivity. It reduces postprandial glucose levels substantially in combination with insulin.

cirrhosis chronic intestinal diseases colonic ulceration

A nurse is caring for a client with elevated blood glucose levels who is to receive alpha-glucosidase inhibitor drug therapy. The nurse understands that this therapy would be contraindicated if the client had which condition? Select all that apply. cirrhosis chronic intestinal diseases type I diabetes severe heart failure colonic ulceration

Insulin glargine (Lantus) Insulin detemir (Levemir)

A nurse must recognize the duration of insulin as to not cause harm to the client with administration of the improper type of insulin. Which insulins are long-acting insulin? (Select all that apply.) Insulin apart (NovoLog) Insulin lispro (Humalog) Insulin glargine (Lantus) Insulin detemir (Levemir) Insulin glulisine (Apidra)

Hypoglycemia Heartburn Nausea

A nurse should monitor a client taking glimepiride (Amaryl) for which of adverse effects? (Select all that apply.) Lactic acidosis Edema Hypoglycemia Heartburn Nausea

3 to 4 hours

A patient is taking chlorpropamide. The nurse warns the patient about the possibility of hypoglycemia within approximately which time frame after taking the drug? 3 to 4 hours 1 to 2 hours 2 to 3 hours 4 to 5 hours

An increase in serum lactate

An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication? A decrease in hemoglobin and hematocrit An increase in serum lactate A decrease in potassium accompanied by an increase in sodium An increase in white blood cells

Thiazolidinediones

As the first-line treatment, a client with type 2 diabetes has tried diet and exercise. When these fail, what may be added as monotherapy or in combination with metformin to control their disease process? Repaglinide A sitagliptin Thiazolidinediones An incretin agent

Metformin (Glucophage) Acarbose (Precose) Miglitol (Glyset)

The nurse is caring for an older adult client who has type 2 diabetes and chronic kidney disease. Which drugs will be used with great caution in this client? (Select all that apply.) Regular insulin Metformin (Glucophage) Acarbose (Precose) Chlorpropamide (Diabinese) Miglitol (Glyset)

Bloating and diarrhea

The nurse is educating a client who is beginning therapy with acarbose and tells the client to take the medication with the first bite of each main meal to help prevent what adverse effect? Dizziness Bloating and diarrhea Nausea and vomiting Chest pain

"Give it by subcutaneous injection immediately before your major meals."

The nurse is instructing a client how to take a prescribed pramlintide. Which would be most appropriate? "Give it by subcutaneous injection immediately before your major meals." "Take the drug orally once a day, preferably in the morning." "Give yourself an injection 1 hour before you eat breakfast and dinner." "Take the drug orally with the first bite of each meal."

Every 1-3 days

The nurse is working with a client who uses an insulin pump for management of type 1 diabetes. The nurse should remind the client that the needle on the pump needs to be changed how often? Every one month Every two weeks Every 5-7 days Every 1-3 days

Ketones in the urine Flushed, dry skin

The nurse who has admitted a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.) Blood glucose 191 mg/dL Ketones in the urine Somnolence Flushed, dry skin Rectal pressure