Nokea
A client is receiving glipizide at a health care facility. The client is also prescribed an anticoagulant. The nurse would be alert for which of the following related to the interaction of these two drugs?
- A. Increased risk of lactic acidosis
- B. Risk of acute renal failure
- C. Increased risk for bleeding
- D. Increased hypoglycemic effect
Correct Answer: D
Rationale: The nurse should observe for increased hypoglycemic effect in the client as the effect of the interaction of sulfonylureas with the anticoagulants, chloramphenicol, clofibrate, fluconazole, histamine-2 antagonists, meth Methyldopa, monoamine oxidase inhibitors (MAOIs), salicylates, sulfonamides, and tricyclic antidepressants. Increased risk of lactic acidosis is an effect of the interaction of metformin with glucocorticoids. Increased risk for bleeding is an effect of the interaction of oral anticoagulants with anti-infective drugs. There is a risk of acute renal failure when iodinated contrast material used for radiologic studies is administered with metformin.
You may also like to solve these questions
After administering glimepiride, the nurse would assess the client for which of the following?
- A. Lactic acidosis
- B. Edema
- C. Hypoglycemia
- D. Heartburn
- E. Nausea
Correct Answer: C,D,E
Rationale: Adverse reactions associated with sulfonylureas, like glimepiride (Amaryl), include hypoglycemia, anorexia, nausea, vomiting, epigastric discomfort, weight gain, heartburn, and various vague neurologic symptoms, such as numbness and weakness of the extremities.
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.
A client is receiving glyburide. The nurse assesses the client for a decrease in the drug's effect if which of the following drugs are initiated?
- A. Atenolol (Tenormin)
- B. Amlodipine (Norvasc)
- C. Phenytoin (Dilantin)
- D. Lithium (Eskalith)
- E. Levothyroxine (Synthroid)
Correct Answer: A,B,C,E
Rationale: Beta blockers (atenolol), calcium channel blockers (amlodipine), hydantoins (phenytoin), and thyroid agents (levothyroxine), among others, can result in decreased hypoglycemic effects of sulfonylureas (glyburide).
A nurse is caring for a client with type 2 diabetes receiving a meglitinide. The nurse reviews the clients medical record based on the understanding that which condition would contraindicate the use of this drug?
- A. Diabetic ketoacidosis
- B. Kidney disease
- C. Severe heart failure
- D. Liver disease
Correct Answer: A
Rationale: Meglitinides are contraindicated in clients with diabetic ketoacidosis and severe endocrine disease. Thiazolidinediones are contraindicated in clients with severe heart failure and used with caution in clients with kidney disease, severe heart failure, and liver disease.
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.