Nokea
Amitriptyline is prescribed for a diabetic patient who has burning foot pain at night. Which of the following information should the nurse include when teaching the patient about the new medication?
- A. Amitriptyline will decrease the depression caused by your foot pain.
- B. Amitriptyline will correct some of the blood vessel changes that cause pain.
- C. Amitriptyline will improve sleep and make you less aware of nighttime pain.
- D. Amitriptyline will help prevent the transmission of pain impulses to the brain.
Correct Answer: D
Rationale: Tricyclic antidepressants decrease the transmission of pain impulses to the spinal cord and brain. Tricyclics also improve sleep quality and are used for depression, but that is not the major purpose for their use in diabetic neuropathy. The blood vessel changes that contribute to neuropathy are not affected by tricyclics.
You may also like to solve these questions
A patient with type 1 diabetes who is on glargine and lispro insulin has called the clinic to report symptoms of a sore throat, cough, fever, and blood glucose level of 11.7 mmol/L. Which of the following information should the nurse tell the patient?
- A. Use only the lispro insulin until the symptoms of infection are resolved.
- B. Monitor blood glucose every 4 hours and notify the clinic if it continues to rise.
- C. Decrease intake of carbohydrates until glycosylated hemoglobin is less than 7%.
- D. Limit intake of calorie-containing liquids until the glucose is less than 6.7 mmol/L.
Correct Answer: B
Rationale: Infection and other stressors increase blood glucose levels and the patient will need to test blood glucose frequently, treat elevations appropriately with lispro insulin, and call the health care provider if glucose levels continue to be elevated. Discontinuing the glargine will contribute to hyperglycemia and may lead to diabetic ketoacidosis (DKA). Decreasing carbohydrate or caloric intake is not appropriate because the patient will need more calories when ill. Glycosylated hemoglobin is not used to test for short-term alterations in blood glucose.
The nurse has completed teaching a patient with type 2 diabetes about taking gliclazide. Which of the following patient statements indicate a need for additional teaching?
- A. Other medications besides the gliclazide may affect my blood sugar.
- B. If I overeat at a meal, I will still take just the usual dose of medication.
- C. When I become ill, I may have to take insulin to control my blood sugar.
- D. My diabetes is not as likely to cause complications as if I needed to take insulin.
Correct Answer: D
Rationale: The patient should understand that type 2 diabetes places the patient at risk for many complications and that good glucose control is as important when taking oral agents as when using insulin. The other statements are accurate and indicate good understanding of the use of gliclazide.
The nurse is assessing a patient who is recovering from an episode of diabetic ketoacidosis and the patient reports feeling anxious, nervous, and sweaty. Which of the following actions should the nurse take first?
- A. Administer 1 mg glucagon subcutaneously.
- B. Obtain a glucose reading using a finger stick.
- C. Have the patient drink 120 mL of orange juice.
- D. Give the scheduled dose of lispro insulin.
Correct Answer: B
Rationale: The patient's clinical manifestations are consistent with hypoglycemia and the initial action should be to check the patient's glucose with a finger stick or order a stat blood glucose. If the glucose is low, the patient should ingest a rapid-acting carbohydrate, such as orange juice. Glucagon might be given if the patient's symptoms become worse or if the patient is unconscious. Administration of lispro would drop the patient's glucose further.
Which of the following laboratory values, noted by the nurse when reviewing the chart of a hospitalized patient with diabetes, indicates the need for rapid assessment of the patient?
- A. Hb A1C of 5.8%.
- B. Noon blood glucose of 2.9 mmol/L.
- C. Hb A1C of 6.9%.
- D. Fasting blood glucose of 7.2 mmol/L.
Correct Answer: B
Rationale: The nurse should assess the patient with a blood glucose level of 2.9 mmol/L for symptoms of hypoglycemia as the normal range is 4-6 mmol/L. The other values are within an acceptable range for a diabetic patient.
The nurse is teaching about meal coverage to a patient with diabetes who has just started on intensive insulin therapy. Which of the following types of insulin should the nurse discuss with the patient?
- A. Glargine
- B. Lispro
- C. Detemir
- D. NPH
Correct Answer: B
Rationale: Rapid- or short-acting insulin is used for mealtime coverage for patients receiving intensive insulin therapy. NPH, glargine, or detemir will be used as the basal insulin.