Nokea
A nurse should monitor a client taking glyburide (DiaBeta) for increased hypoglycemic effect if which of the following drugs are initiated?
- A. Ranitidine (Zantac)
- B. Warfarin (Coumadin)
- C. Digoxin (Lanoxin)
- D. Lithium (Eskalith)
- E. Amitriptyline (Elavil)
Correct Answer: A,B,E
Rationale: H2 antagonists (ranitidine), anticoagulants (warfarin), and tricyclic antidepressants (amitriptyline), among others, can result in increased hypoglycemic effects of sulfonylureas (glyburide).
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The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL. Which of the following would the nurse most likely give?
- A. Orange or other fruit juice
- B. Glucose tablets
- C. Insulin glargine (Lantus)
- D. Hard candy
- E. Insulin detemir (Levemir)
Correct Answer: A,B,D
Rationale: Methods of terminating a hypoglycemic reaction include the administration of one or more of the following: orange or other fruit juice, hard candy or honey, glucose tablets, glucagon, or glucose 10% or 50% IV.
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.
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.
A nurse at a health care facility is assigned to administer insulin to the client. Which of the following interventions should the nurse perform before administering each insulin dose?
- A. Inspect the previous injection site for inflammation.
- B. Keep prefilled syringes horizontally.
- C. Check for symptoms of myalgia or malaise.
- D. Mix the insulin with sterile water in the syringe.
Correct Answer: A
Rationale: The nurse should check the previous injection site before administering each insulin dose. The injection sites should be rotated to prevent lipodystrophy. Prefilled syringes should not be kept horizontally; they should be kept in a vertical or oblique position to avoid plugging the needle. The nurse checks for symptoms of myalgia or malaise when administration of metformin leads to lactic acidosis. Insulin should not be mixed with other drugs in the syringe. Some types of insulin may be combined in one syringe, but sterile water is never used.
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.