Nokea
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.
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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 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.
After teaching a group of nursing students about antidiabetic drugs, the instructor determines that the teaching was successful when the students identify which of the following as producing the glucose-lowering effects by delaying the digestion and absorption of carbohydrates in the intestine?
- A. Glimepiride (Amaryl)
- B. Metformin (Glucophage)
- C. Pioglitazone (Actos)
- D. Miglitol (Glyset)
- E. Acarbose (Precose)
Correct Answer: D,E
Rationale: The alpha-glucosidase inhibitors, acarbose (Precose) and miglitol (Glyset), produce their glucose-lowering effects by delaying the digestion and absorption of carbohydrates in the intestine. Glimepiride is a sulfonylurea. Metformin sensitizes the liver to circulating insulin levels and reduces hepatic glucose production. Pioglitazone decreases insulin resistance and increases insulin sensitivity by modifying several processes, resulting in decreased hepatic glucogenesis (formation of glucose from glycogen) and increased insulin-dependent muscle glucose uptake.
A client is receiving metformin (Glucophage). The nurse suspects that the client is developing lactic acidosis based on assessment of which of the following?
- A. Malaise
- B. Hypertension
- C. Tachypnea
- D. Abdominal pain
- E. Muscular pain
Correct Answer: A,C,D,E
Rationale: Symptoms of lactic acidosis include malaise, abdominal pain, tachypnea, shortness of breath, and muscular pain.
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.