Nokea
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.
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A nurse is preparing a presentation for a local community group about diabetes. Which of the following would the nurse include when describing type 1 diabetes?
- A. Insidious onset
- B. Occurs before age 20
- C. Insulin supplementation required for survival
- D. Formally known as non-insulin-dependent diabetes mellitus
- E. Obesity a risk factor
Correct Answer: B,C
Rationale: Type 1 diabetes is formerly known as insulin-dependent diabetes mellitus. It usually has a rapid onset and occurs before age 20. Those with type 1 diabetes produce insulin in insufficient amounts and therefore must have insulin supplementation to survive. Type 1 diabetes is an autoimmune disorder; therefore, obesity is not a risk factor.
A client has been prescribed acarbose. Which of the following interventions should the nurse perform to promote an optimal response to the medication?
- A. Administer the drug with breakfast.
- B. Expect to add an oral sulfonylurea with the drug bends
- C. Administer the drug with the first bite of the meal.
- D. Report unusual somnolence to the primary health care provider.
Correct Answer: C
Rationale: The nurse should administer acarbose to the client with the first bite of the meal. The nurse needs to administer glyburide (Micronase) with breakfast. An oral sulfonylurea will likely be added to metformin if the client does not experience a response in 4 weeks using the maximum dose of metformin. Clients taking metformin may experience unusual somnolence, of which the nurse should inform the primary health care provider.
A nurse is caring for a client who has developed a hypoglycemic reaction. Which of the following interventions should the nurse perform if swallowing and gag reflexes are present In the client?
- A. Administer glucagon by the parenteral route.
- B. Administer the insulin via insulin pump.
- C. Administer oral antidiabetics to the client.
- D. Give oral fluids or candy.
Correct Answer: D
Rationale: The nurse should administer oral fluids or candy to the hypoglycemic client with swallowing and gag reflexes. If the client is unconscious, the nurse should administer glucose or glucagon parenterally. The nurse should administer insulin through an insulin pump for diabetic clients who are pregnant or have had a renal transplant. Oral antidiabetic drugs are administered to clients with type 2 diabetes.
A nurse is preparing to administer a long-acting insulin to a client. Which of the following might the nurse administer?
- A. Insulin aspart (NovoLog)
- B. Insulin lispro (Humalog)
- C. Insulin glargine (Lantus)
- D. Insulin detemir (Levemir)
- E. Insulin glulisine (Apidra)
Correct Answer: C,D
Rationale: Insulin glargine (Lantus) and insulin detemir (Levemir) are long-acting insulins with a duration of 24 hours. Insulin aspart, lispro, and glulisine are rapid-acting insulins.
As part of the ongoing assessment of a client receiving insulin detemir, the nurse would suspect that the insulin is not effective based on assessment of which of the following?
- A. Increased thirst
- B. Increased urination
- C. Increased appetite
- D. Confusion
- E. Abdominal pain
Correct Answer: A,B,E
Rationale: If the insulin was not effective, the client would exhibit signs and symptoms of hyperglycemia including drowsiness, dim vision, thirst, nausea, vomiting, abdominal pain, loss of appetite, acetone breath, and excessive urination.