Diabetes Meds

Metformin 2 g by mouth is prescribed for a client with type 2 diabetes. Each tablet contains 500 mg. How many tablets will the nurse administer? Record your answer using a whole number.

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The nurse educator is providing information about different insulin types. Which type of insulin can be safely mixed with regular human insulin in the same syringe? Insulin glargine Insulin detemir Insulin lispro mix 75/25 Isophane insulin neutral protamine hagedorn (NPH)

Isophane insulin neutral protamine hagedorn (NPH) Isophane insulin NPH is safe to mix with regular human insulin. No other insulin type should be mixed with insulin glargine, insulin detemir, or insulin lispro mix 75/25.

The nurse is teaching a 10-year-old child with type 1 diabetes about insulin requirements. Which statement by the nurse correctly identifies when insulin needs decrease? "Insulin needs often decrease when puberty is reached." "When there is an infection is present, the body requires less insulin." "Emotional stress can cause insulin needs to decrease." "Increased muscle activity such as exercise, cause insulin needs to decrease."

"Increased muscle activity such as exercise, cause insulin needs to decrease." Exercise reduces the body's need for insulin. Increased muscle activity accelerates transport of glucose into muscle cells, thus producing an insulin like effect. With increased growth and associated dietary intake, the need for insulin increases during puberty. An infectious process may require increased insulin. Emotional stress increases the need for insulin.

A client states, "I keep my insulin in the refrigerator because that is where my parents kept it." Which reason will the nurse include when explaining why insulin should be stored at room temperature? Its potency and effectiveness are maximized. Absorption is enhanced and local irritation is decreased. It is more convenient and drawing insulin into the syringe is facilitated. Adherence of insulin to the syringe and resistance upon injection are decreased.

Absorption is enhanced and local irritation is decreased. Insulin that is close to body temperature prevents vasoconstriction at the site and decreases irritation of tissues. Insulin can be stored at room temperature for up to 1 month but must be kept away from heat or sunlight. Inappropriate storage of insulin can decrease its stability and decrease, not increase, its therapeutic action. Although it may be more convenient to keep insulin in the refrigerator, this is not a valid rationale; temperature of the solution does not increase the viscosity of insulin. Neither adherence of insulin to the syringe nor decreased resistance upon injection occurs.

The nurse prepares to administer extended-release metformin to an older adult who has asked that it be crushed because it is difficult to swallow. Which rationale will prompt the nurse to ask the provider for a different form of metformin? This medication has a wax matrix frame that is difficult to crush. The medication has an unpleasant taste, which most clients find intolerable if crushed. If crushed, this medication irritates mucosal tissue and can cause oral and esophageal ulcer formation. Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.

Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring. The slow-release formulary will be compromised, and the client will not receive the entire dose if it is chewed or crushed. The capsules are not difficult to crush. Irritation of the mucosal tissue is not the reason the medication should not be crushed; however, this medication should be given with meals to prevent gastrointestinal irritation. Although taste could be a factor, it is not the priority issue.

The nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin would the nurse conclude has the fastest onset of action? NPH insulin Insulin lispro Regular insulin Insulin glargine

Insulin lispro Insulin lispro has an onset of 0.25 hours, a peak action of 0.5 to 1.5 hours, and a duration of 3 to 4 hours. Insulin glargine has an onset of 1 to 1.5 hours, no peak action, and a duration of 20 to 24 hours. Neutral protamine Hagedorn (NPH) or intermediate-acting insulin has an onset of 1.5 hours, a peak action of 4 to 12 hours, and a duration of 18 to 24 hours. Regular insulin has an onset of 0.5 hours, a peak action of 1 to 5 hours, and a duration of 6 to 10 hours.

Which action by the client indicates the need for further instruction on insulin administration? Select all that apply. One, some, or all responses may be correct. Aspirating before administering the dose Using a 27-gauge needle to administer the insulin Administering rapid-acting insulin in the abdomen Holding the needle in place for several seconds after administering the insulin Identifying areas where 1 inch of subcutaneous fat can be pinched for insulin administration

Aspirating before administering the dose Aspiration is not performed for insulin administration. The client would use a 27-gauge needle to administer the dose of insulin. The abdomen is the appropriate location for administering rapid-acting insulins. The client would hold the needle in place for several seconds after administering the insulin. Appropriate locations to administer insulin are those where 2.5 cm (1 inch) of subcutaneous fat can be pinched.

A client with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving and the primary health care provider writes a prescription to discontinue the 7:00 AM dose of insulin and to administer glyburide 5 mg twice daily. After administering the glyburide at 8:30 AM, the nurse sees that the insulin had already been administered at 7:00 AM. Which initial action would the nurse take? Measure the vital signs. Notify the primary health care provider. Administer 15 G of fast acting carbohydrates Check blood glucose for hypoglycemia.

Check blood glucose for hypoglycemia. Checking blood glucose level for signs of hypoglycemia is a priority because both these medications can lower the blood sugar. When any medication error is discovered, the first step is assessing the client. Also, before notifying the primary health care provider, it is essential to have as much information as possible; the primary health care provider will need to know the client's blood sugar. In addition, if the blood sugar is low and the client is responsive and alert, the nurse can provide an immediate snack. Not immediately assessing for or not treating symptoms of hypoglycemia delays care of the client. Although measuring the vital signs may be done eventually, it is not the priority because the error was identified before the oral glyburide had time to precipitate an effect. Administering 15 G of fast acting carbohydrates would not be done initially; a blood glucose level would be checked first.

Which mechanism of action explains how glyburide decreases serum glucose levels? Stimulates the pancreas to produce insulin Accelerates the liver's release of stored glycogen Increases glucose transport across the cell membrane Decreases absorption of glucose from the gastrointestinal system

Stimulates the pancreas to produce insulin Glyburide, an antidiabetic sulfonylurea, stimulates insulin production by the beta cells of the pancreas. Accelerating the liver's release of stored glycogen occurs when serum glucose drops below normal levels. Increasing glucose transport across the cell membrane occurs in the presence of insulin and potassium.Antidiabetic medications of the biguanide chemical class improve sensitivity of peripheral tissue to insulin, which ultimately increases glucose transport into cells. Beta cells must have some function to enable this medication to be effective.

A child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. Which time would the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur? Before noon In the afternoon Within 30 minutes During the evening

In the afternoon NPH insulin is an intermediate-acting insulin that peaks approximately 6 to 8 hours after administration. It was administered at 7:00 AM, so between 1:00 PM and 3:00 PM is when the nurse would anticipate that a hypoglycemic reaction would occur. Noon is when a reaction from a short-acting insulin is expected. Short- acting insulin peaks 2 to 4 hours after administration. Within 30 minutes of administration is when a reaction from a rapid-acting insulin is expected. Rapid-acting insulin peaks 30 to 60 minutes after administration. During the evening or nighttime is when a reaction from a long-acting insulin is expected. Long-acting insulin has a small peak 10 to 16 hours after administration.