adn 240 test 1- metabolism

The laboratory comes to draw an Hgb A1c. The client asks the nurse what this test represents. Which statement would be correct?

"This test reflects the average blood glucose over a period of approximately 2-3 months."

A client is ordered prednisone daily. Which statement best explains why the nurse should instruct the client to take this drug in the morning?

- Prednisone has a longer half-life with morning administration, making it more effective. - Taking the drug at the same time every day establishes a regular routine, reducing the risk of forgetting a dose. - Prednisone is best absorbed when taken on an empty stomach, first thing in the morning. - Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern.

what is glipizide

- sulfonylurea- type 2 DM oral However, oral secretagogues do not require the presence of glucose to work. This is the main reason they can cause hypoglycemia (patient MUST eat before use) - take with first meal of the day - Important to teach about taking with meals - Side and adverse effects: hypoglycemia - Interactions: alcohol, beta blockers

A nurse in a diabetes clinic receives phone calls from four clients with type 1 diabetes. Which client's call would be the highest priority for the nurse to return?

A client reporting "My skin appears drier than usual." A client reporting "I have been experiencing nausea and vomiting this morning, and can only keep fluids down." A client reporting "I'm thirsty all the time. I just can't get enough to drink." A client reporting "I noticed that my urine has a foul odor."

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer

I.M. or subcutaneous glucagon. I.V. bolus of dextrose 50%. 10 units of fast-acting insulin. 15 to 20 g of a fast-acting carbohydrate such as orange juice.

The nurse is developing a teaching plan for the client with hepatitis A. What should the nurse tell the client to do?

Increase carbohydrates and protein in the diet.

The nurse is teaching a client who is taking insulin about the signs of diabetic ketoacidosis, which include:

Kussmaul's respirations. excessive hunger. dry, flaky skin. high blood pressure.

The nurse has been assigned to a client who has had diabetes for 10 years. The nurse gives the client's usual dose of regular insulin at 7 a.m. At 10:30 a.m., the client has light-headedness and sweating. The nurse should contact the physician, report the situation, background, and assessment, and recommend intervention for:Metabolic acidosis. Ketoacidosis. Hyperglycemia. Hypoglycemia.

Metabolic acidosis. Ketoacidosis. Hyperglycemia. Hypoglycemia

A client has chronic pancreatitis. What should the nurse teach the client to do to monitor the effectiveness of pancreatic enzyme replacement?

Observe stools for steatorrhea. Record daily fluid intake. Perform glucose fingerstick tests twice a day. Test urine for ketones.

early signs of hypoglycemia

Sweating, tremors, and tachycardia, thirst, and anxiety

A client has type 1 diabetes. Her husband finds her unconscious at home and administers glucagon, 0.5 mg subcutaneously. She awakens in 5 minutes. Why should her husband offer her a complex carbohydrate snack as soon as possible?

To restore liver glycogen and prevent secondary hypoglycemia

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?

blood glucose level 1,100 mg/dl (61.05 mmol/L)

Using a sliding scale schedule, the nurse is preparing to administer an evening dose of regular insulin to a client who is receiving total parenteral nutrition (TPN). On which information should the nurse base the dosage?

client's dietary intake for the evening meal and snack amount of TPN fluid the client has received since the last dose of insulin fasting blood glucose level obtained earlier in the day glucometer reading of the client's glucose level obtained immediately before administering the insulin

The nurse is assessing a client with Addison disease about taking a glucocorticoid replacement. Which is the best indicator that the medication is having the intended effect?

daily weight

The nurse is conducting an assessment of an elderly client who is blind. Which of the following would the nurse expect to be present in the medical history?

diabetes mellitus - retinopathy

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

glucagon

glucocorticoid

hormone from the adrenal cortex that raises blood sugar and reduces inflammation

A client with cirrhosis begins to develop ascites. The health care provider prescribes spironolactone to treat the ascites. The nurse should monitor the client closely for which drug-related adverse effect?

hyperkalemia

Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m. (1400), the client has a capillary glucose level of 250 mg/dl for which the client receives 8 units of regular insulin. The nurse should expect the dose's

onset to be at 2 p.m. (1400) and its peak to be at 3 p.m.(1500). onset to be at 2:15 p.m. (1415) and its peak to be at 3 p.m.(1500). onset to be at 4 p.m. (1600) and its peak to be at 6 p.m.(1800). onset to be at 2:30 p.m. (1430) and its peak to be at 4 p.m.(1600).

A client with type 1 diabetes mellitus is admitted to the emergency department. Which respiratory pattern in a client with diabetes mellitus requires immediate action?

short expirations and inspirations regular depth of respirations with frequent pauses deep, rapid respirations with long expirations shallow respirations alternating with long expirations

The nurse is assessing the client's understanding of the use of medications. Which medication may cause a complication with the treatment plan of a client with diabetes?

steroids

When teaching a client when to take glipizide to maximize the effectiveness of the drug, the nurse should instruct the client to perform which action?

take 30 minutes before breakfast

The health care provider has prescribed pancreatic enzyme replacements for a client with chronic pancreatitis. When should the nurse tell the client about how to take them to obtain the most therapeutic effect?

three times daily between meals every 4 hours, at specified times with each meal and snack in the morning and at bedtime