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A client at a health care facility has been prescribed diazoxide for hypoglycemia due to hyperinsulinism. After administration, the nurse would assess the client for which adverse reaction?
- A. Myalgia
- B. Tachycardia
- C. Flatulence
- D. Epigastric discomfort
Correct Answer: B
Rationale: The nurse should monitor for tachycardia, congestive heart failure, sodium and fluid retention, hyperglycemia, and glycosuria as the adverse reactions in the client receiving diazoxide drug therapy. Myalgia, fatigue, and headache are the adverse reactions observed in clients undergoing pioglitazone HCl drug therapy. Flatulence is one of the adverse reactions found in clients receiving metformin drug therapy. Epigastric discomfort is one of the adverse reactions observed in clients receiving acetohexamide drugs.
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A client receives insulin lispro at 8 a.m. The nurse would be alert for signs and symptoms of hypoglycemia at about which time?
- A. 8:15 a.m.
- B. 9 a.m.
- C. 10 a.m.
- D. 11 a.m.
Correct Answer: B
Rationale: Insulin lispro reaches its peak action in 30 minutes to 1.5 hours. Therefore, the client's greatest risk for hypoglycemia would be during this time or about 9 a.m. Onset of action occurs in 5 to 10 minutes, so the drug would begin being effective at this time.
A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this client?
- A. Assess the skin for ulcers, cuts, and sores.
- B. Observe the client for hypoglycemic episodes.
- C. Monitor the client for lipodystrophy.
- D. Document family medical history.
Correct Answer: B
Rationale: As the ongoing assessment activity, the nurse should observe the client for hypoglycemic episodes. Documenting family medical history and assessing the client's skin for ulcers, cuts, and sores should be completed before administering the drug. Lipodystrophy occurs if the sites of insulin injection are not rotated.
A nurse is caring for a client receiving insulin detemir 10 units at bedtime. Which of the following drugs, if started, would most likely require a decrease in the dosage of insulin?
- A. Sulfamethoxazole/trimethoprim (Septra)
- B. Metoprolol (Lopressor)
- C. Fenofibrate (Tricor)
- D. Diltiazem (Verapamil)
- E. Albuterol (Ventolin)
Correct Answer: A,B,C
Rationale: Sulfonamides (sulfamethoxazole/trimethoprim), beta-blocking drugs (metoprolol), and fibrates (fenofibrate), among others, can increase the effect of insulin and require a decrease in insulin dosage to control the client's diabetes. Diltiazem and albuterol decrease the effect of insulin, requiring an increase in the dosage.
A client is prescribed miglitol. The nurse would instruct the client to administer this drug at which time?
- A. At bedtime
- B. Three times a day with the first bite of a meal
- C. 30 minutes before eating breakfast
- D. Before or after a meal during the day
Correct Answer: B
Rationale: Miglitol is given three times a day with the first bite of the meal because food increases absorption.
After administering insulin detemir to a client with diabetes, the nurse suspects that the client is developing hypoglycemia based on assessment of which of the following?
- A. Increased thirst
- B. Increased urination
- C. Headache
- D. Confusion
- E. Diaphoresis
Correct Answer: C,D,E
Rationale: The symptoms of hypoglycemia include fatigue, weakness, nervousness, agitation, confusion, headache, diplopia, convulsions, dizziness, unconsciousness, hunger, nausea, diaphoresis, and numbness or tingling of the lips or tongue. Increased thirst and urination suggest hyperglycemia.