Chapter 38: Agents to Control Blood Glucose Levels
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 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.
A patient 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
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
A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?
Exogenous insulin is required for life.
Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.
False
What would alert the nurse to suspect that a client is developing ketoacidosis?
Fruity breath odor
Which would a nurse identify as an example of a sulfonylurea?
Glyburide
The nurse is interviewing a client who was diagnosed with type 2 diabetes about four months ago. The client never records glucometer readings but says that everything is just fine. What laboratory test does the nurse anticipate the health care provider will order for this client?
HbA1c
A nurse should monitor a client taking glimepiride (Amaryl) for which of adverse effects? (Select all that apply.)
Hypoglycemia Heartburn Nausea
When administering insulin, what would be most appropriate?
Insert the needle at a 45-degree angle for injection.
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.
Which is an example of long acting insulin?
Insulin glargine (Lantus)
A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?
Insulin is needed because the beta cells of the pancreas are no longer functioning.
What is an example of rapid acting insulin?
Insulin lispro (Humalog)
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.
A patient is prescribed pramlintide (Symlin). How will it assist in controlling the patient's blood sugar?
It slows gastric emptying.
The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's top priority intervention related to this medication?
Make sure the client's breakfast is available in the next 5-10 minutes.
Which would be least appropriate when administering insulin by subcutaneous injection?
Massaging the site after removing the needle
After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide?
Metformin
The school nurse identifies more children with type 2 diabetes each year and recognizes that this trend is mainly attributed to what issue?
Obesity and inadequate exercise
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.
The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL. Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.)
Orange or other fruit juice Glucose tablets Hard candy
A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600. The physician has ordered the patient to receive an initial dose of 25 units of insulin. What type of insulin will be administered intravenously?
Regular insulin
A nurse is preparing an in-service presentation for a group of staff members on diabetes. Which would the nurse include as the primary delivery system for insulin?
Subcutaneous injection
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
Glycosylated hemoglobin measures average blood glucose over what time period?
The past 3 or 4 months
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
Glycosylated hemoglobin levels provide reliable evidence of blood glucose control.
True
Regular insulin may be administered intravenously or intramuscularly in an emergency situation.
True