Pharmacology II Prep U Chapter 38: Agents to Control Blood Glucose Levels

A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?

It slows gastric emptying.

When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?

regular

What type of insulin will most likely be administered intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L)?

regular insulin

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, who is 42 years old and 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."

What statement would be appropriately included in the teaching concerning type 2 diabetes?

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

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.

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 glargine (Lantus) * Insulin detemir (Levemir)

The demonstration of what symptom would suggest that an insulin-dependent client is experiencing a hypoglycemic reaction? Select all that apply.

* weakness * diaphoresis * mental confusion * increased pulse rate

The nurse is preparing to administer a mixture of 12 units regular insulin and 45 units NPH insulin to a client with a blood sugar of 378 mg/dL. After the nurse draws the medication into the syringe, what is the nurse's next action?

Check the dosage with another nurse.

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?

Assess the most recent hemoglobin A1C levels.

A client receives regular insulin at 8:00 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 10:00 AM and 12:00 PM

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 AM and 9:30 AM

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.

Clients with type 2 diabetes have nonfunctioning beta pancreatic cells.

False

Which would the nurse identify as an effect of somatostatin on blood glucose?

Decreased glucagon release

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration?

Do not give pramlintide in the same site where insulin is administered.

Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which action does this enable?

Entry of glucose into the cells

Stress typically results in hypoglycemia.

False

The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not records glucometer readings but reports no concerns. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1c

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.

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.

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

Oral

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 patient at a health care facility has been prescribed diazoxide for hypoglycemia due to hyperinsulinism. What adverse reactions to the drug should the nurse monitor for in the patient?

Tachycardia

Amylin is a peptide hormone secreted with insulin by the beta cells of the pancreas and is important in the regulation of glucose control during the postprandial period. True or false?

True

Regular insulin may be administered intravenously or intramuscularly in an emergency situation.

True

A patient with type 1 diabetes has come to the clinic for a routine follow-up appointment. While assessing the patient's skin, the nurse observes brown spots on his lower legs. What might these spots indicate?

Widespread changes in the blood vessels

Which factor would prohibit the administration of glipizide?

allergy to sulfonamides

A hospital client with a diagnosis of type 1 diabetes is prescribed Humulin R on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication?

between 09:45 and 10:45

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

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

insulin lispro

Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn?

liver enzymes

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which intervention should the nurse perform if swallowing and gag reflexes are present in the patient?

Give oral fluids 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

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

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

It slows the rate of inactivation of the incretin hormones.

A client 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.

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 client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

Regular

Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication?

garlic

A nurse at a health care facility is caring for a client who has been prescribed insulin for the first time. Which preadministration assessments should the nurse perform before the first dose of insulin is given?

general assessment of the skin

The nurse is caring for a client who is taking glyburide as treatment for type 2 diabetes mellitus. The health care provider has added a corticosteroid to this client's medication regimen for treatment of a severe allergic reaction. The nurse knows that this drug combination may cause what adverse effect on this client?

hyperglycemia

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:

weakness, sweating, and decreased mentation.

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

Glyburide

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

Massaging the site after removing the needle

What should be the nurse's initial response when a client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy?

Perform a blood sugar analysis.

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

Increases insulin release