Metabolism & Anti-diabetic Medications

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."

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.

The peak of action of insulin aspart is

1-2 hours when you'd expect to see the glucose at its lowest point after insulin given

Duration of action for Lantus is

24hrs

When preparing to administer an insulin injection, the nurse would use which sized needle?

25 gauge, ½ inch

You have drawn up 10 units of 70/30 insulin into a syringe. This would have ______units of regular insulin in the syringe

3

Most oral antidiabetic drugs should be taken at least

30 minutes before meals

The nurse is educating a newly diagnosed diabetic who must learn how to give himself insulin injections. The nurse tells the client that insulin is absorbed fastest from which area of injection?

Abdomen

A 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 hypoglycemia

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

A female client visits the physician'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.

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

Which is a non-insulin injectable antidiabetic drug?

Exenatide (Byetta)

Which is the best indicator of overall diabetic control?

Glycosylated hemoglobin levels

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.

Which insulin would the nurse need to administer as a separate injection if the order also included NPH insulin?

Glargine

After teaching a group of students about sulfonylureas, the instructor determines that the teaching was successful when the students identify which agent as a second-generation sulfonylurea? (Select all that apply.)

Glimepiride Glyburide

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.)

Headache Confusion Diaphoresis

A nurse should monitor a client taking glimepiride (Amaryl) for which of adverse effects? (Select all that apply.)

Hypoglycemia Heartburn Nausea

The nurse is explaining the action of exenatide to a patient. Which would the nurse include?

Increase in insulin resistance

A patient is receiving acarbose. What would the nurse incorporate into the teaching plan for this patient about the action of the drug?

Inhibits an enzyme to delay glucose absorption

Which insulins are long-acting insulin? (Select all that apply.)

Insulin glargine (Lantus) Insulin detemir (Levemir)

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.

The nurse helps the parents to understand that in young children, hypoglycemia may manifest as what signs or symptoms? (Select all that apply.)

Irritability Impaired mental functioning Lethargy

An example of an intermediate acting insulin is

Isophane or NPH

Which statement accurately describes the action of metformin?

It decreases intestinal absorption of glucose and improves insulin sensitivity.

A common sulfonylurea is

glipizide

A glucose elevating hormone that can be given if a patient has hypoglycemia and cannot be aroused is

glucagon

A patient is prescribed pramlintide (Symlin). How will it assist in controlling the patient's blood sugar?

It slows gastric emptying.

Long acting insulins

Lantus & Levemir

What two insulin products are most at risk of being confused?

Lantus insulin and lente insulin

A patient receives 25 units of NPH insulin at 7 AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

Late afternoon

Rapid acting insulins with onset of action in 15 minutes

Lispro or Aspart

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.

The nurse is caring for a client, age 77 years, who has type 2 diabetes and chronic kidney disease. Which drugs will be used with great caution in this client? (Select all that apply.)

Metformin (Glucophage) Exenatide (Byetta) Miglitol (Glyset)

Insulin with a 4-8 hour peak

NPH

Isophane suspension insulin

NPH Insulin

What best describes type 1 diabetes? (Select all that apply.)

Occurs before age 20 Insulin supplementation is required for survival

Before giving any antidiabetic drug it is most important to know the patient's most recent

glucose

Before insulin administration you should review the results of the

glucose

Insulin with a peak in 2.5 hours

Regular

Short Acting insulin with onset of action 30-60 minutes

Regular Insulin

Which produce their glucose lowering effect by decreasing insulin resistance and increasing insulin sensitivity? (Select all that apply.)

Rosiglitazone (Avandia) Pioglitazone (Actos)

Glycosylated hemoglobin measures average blood glucose over what time period?

The past 3 or 4 months

Meglitinides should be administered at what time?

With the first bite of a meal

The most common adverse effects with metformin are

abdominal bloating and cramping

Hypoglycemia symptoms may include (Select all that apply)

acute change in mental status profuse sweating loss of consciousness tremors

THe current bottle of insulin being used by a patient in his home should be stored

at room temperature

Most antidiabetic drugs can cause __________________ if the person doesn't consume a meal shortly after taking

hypoglycemia

Insulin is a hormone released by the pancreatic beta cells in response to a rise in glucose levels and what else?

incretins

TWo insulins that can be mixed are: Select the two that apply

isophane regular

Select the two Rapid acting insulins

lispro aspart

Lactic acidosis can occur with

metformin (Glucophage)

The antidiabetic drug that should not be given the day the patient is having a radiologic study with iodinated contrast media and for at least 48 hours after is

metformin (Glucophage)

Symptoms of lactic acidosis which can occur with metformin include: (Select all that apply)

muscle pain cramping diarrhea tiredness fatigue abdominal pain

Metformin is contraindicated in patients with

renal disease

A drug in the class of the dipetidyl peptidase IV inhibitors is

sitagliptin (Januvia)

Primary route of insulin, unless otherwise specified is

subcutaneous

The best way to rotate injection sites is to

use the same general location for 1 week this gives this extremity or area a full rest before going back to it again for injections

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.