A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) Show -Expect urine to be darkened. -Monitor weight daily. -Increase calcium intake. -Use oral contraceptives to avoid pregnancy. -Take tablets whole. -Expect urine to be darkened. (Darkened urine may be an indication of hepatotoxicity and should be reported to the provider.) -Monitor weight daily. (Pioglitazone may lead to fluid retention and worsen heart failure. Clients should monitor weight and report any rapid gains to the provider.) !!! -Increase calcium intake. (Pioglitazone increases the risk of fractures in women. Clients should be advised to exercise and ensure adequate intake of vitamin D and calcium to protect bone health.) !!! -Use oral contraceptives to avoid pregnancy. (Pioglitazone decreases the effect of oral contraceptives and can cause ovulation in premenopausal women. Clients should be advised to use another form of contraception to avoid pregnancy.) -Take tablets whole. (Pioglitazone may be crushed and mixed with food for ease of swallowing.) A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide? -"Glipizide absorbs the excess carbohydrates in your system." -"Glipizide stimulates your pancreas to release insulin." -"Glipizide replaces insulin that is not being produced by your pancreas." -"Glipizide prevents your liver from destroying your insulin." -"Glipizide absorbs the excess carbohydrates in your system." (It is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. This is not the mechanism of action.) -"Glipizide stimulates your pancreas to release insulin." (It is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. These medications help to lower blood glucose levels in clients who have type 2 DM using several methods, including reducing glucose output by the liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas.) !!! -"Glipizide replaces insulin that is not being produced by your pancreas." (This explanation is closer to the mechanism of action of exogenous insulin, which is insulin that the client takes subcutaneaously. Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents.) -"Glipizide prevents your liver from destroying your insulin." (Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. Sulfonylurea agents reduce the glucose output of the liver.) A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin? -Insulin glargine has a duration of 3 to 6 hr. -Insulin glargine has a duration of 6 to 10 hr. -Insulin glargine has a duration of 16-24 hr. -Insulin glargine has a duration of 18 to 24 hr. -Insulin glargine has a duration of 3 to 6 hr. (This is for short duration insulins.) -Insulin glargine has a duration of 6 to 10 hr. (This is for short duration insulins.) -Insulin glargine has a duration of 16-24 hr. (This is for intermediate duration insulins.) -Insulin glargine has a duration of 18 to 24 hr. (Insulin glargine is a long duration insulin that has a duration of 18 to 24 hr. It is only dosed once a day.) !!! A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication? -Grapefruit juice -Grapefruit juice -Milk (Does not interact with chlorpropamide.) -Alcohol (The nurse should teach the client to avoid alcohol while taking this medication to prevent a disulfiram reaction, such as nausea, headache, and hypoglycemia.) !!! -Coffee (Caffeine or coffee does not interact with chlorpropamide.) A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? -14 units -28 units -32 units -42 units -14 units -28 units -32 units -42 units (Each order of for units of insulin is combined in the same syringe. The nurse should withdraw the regular insulin into the syringe first.) !!! A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? - Discard the NPH solution if it appears cloudy. -Shake the insulin vigorously before loading the syringe. -Expect the NPH insulin to peak in 6-14 hr. -Freeze unopened insulin vials. - Discard the NPH solution if it appears cloudy. (The client should discard regular insulin if it appears cloudy.) -Shake the insulin vigorously before loading the syringe. (The client should gently roll the NPH insulin before loading the syringe to disperse the mixture without creating bubbles.) -Expect the NPH insulin to peak in 6-14 hr. (NPH insulin is an intermediate-acting insulin. Its onset of action is 1 to 2 hr, peaking at 6 to 14 hr. Its duration of action is 16 to 24 hr. The client is at risk for hypoglycemia during the peak time.) !!! -Freeze unopened insulin vials. (the unopened insulin vials should be stored in the refrigerator.) A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take? -Give the insulin at 0700. -Give the insulin when the breakfast tray arrives. -Give the insulin 30 min after breakfast with the client's other routine medicines. -Give the insulin at 0730. -Give the insulin at 0700. (This is too early administration.) -Give the insulin when the breakfast tray arrives. (Too late administration.) -Give the insulin 30 min after breakfast with the client's other routine medicines. ( Too late administration. The client's blood glucose is likely to be high and the client might be experiencing symptoms of hyperglycemia.) -Give the insulin at 0730. (Regular insulin has an onset of 30-60 minutes and should be given at a specific time before meals, usually within 30 min. The nurse should always check the blood glucose levels prior to administering short-acting insulin.) !!! A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via external insulin pump. Which of the following statements by the client indicates a need for further teaching? -"I will change the needle every 3 days." -"I should store all unused insulin in the refrigerator." -"If I skip lunch, I will skip my mealtime dose of insulin." -"I will use insulin glargine in my insulin pump." -"I will change the needle every 3 days." (The infusion set should be changed every 1 to 3 days to prevent infection. Clients should know how to operate the pump, adjust the settings, and respond to alarms.) -"I should store all unused insulin in the refrigerator." (Clients should refrigerate insulin that is not in use to maintain potency, prevent exposure to sunlight, and inhibit bacterial growth. Insulin in use should be kept at room temperature for up to 1 month to reduce irritation at the injection site.) -"If I skip lunch, I will skip my mealtime dose of insulin." (If a meal is skipped, the mealtime dose should not be given. The client also should know how to adjust the amount of insulin based on blood glucose results.) -"I will use insulin glargine in my insulin pump." (The client should use a short-acting insulin in the insulin pump. The insulin pump is designed to administer rapid-acting or short-acting insulin 24 hr a day. Insulin glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24-hr period.) !!! A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? -Keep the open vial of insulin at room temperature. -Inject the insulin into a large muscle. -Aspirate the medication prior to administration. -Administer the insulin in two separate injections. -Keep the open vial of insulin at room temperature. (in order to minimize tissue injury and to reduce the risk for lipodystrophy.) !!! -Inject the insulin into a large muscle. (The client should inject the medication into subcutaneous tissue.) -Aspirate the medication prior to administration. (Not necessary) -Administer the insulin in two separate injections. (The client should mix compatible solutions, such as regular insulin and NPH insulin, to reduce the need for an additional injection and reduce the risk for lipodystrophy.) A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? -Inspect vials for contaminants. (With the exception of NPH insulin, all insulin today is supplied as a clear, colorless solution. Do not use insulin that is colored, cloudy, or has formed a precipitate.) -Roll NPH vial between palms of hands. (bc NPH is a suspension, the particles must be evenly distributed, gently. If granules or clumps are present after mixing, discard the solution.) -Inject air into NPH insulin vial. -Inject air into regular insulin vial. -Withdraw short-acting insulin into syringe. (Of the longer-acting insulin available, only NPH insulin is mixed with short-acting insulin. When two insulins are mixed, withdraw the short-acting insulin first to avoid contaminating the stock vial with NPH insulin.) -Add intermediate insulin to syringe. (The mixture is stable for 28 days.) A nurse is teaching a client who has a new prescription for NPH insulin. Which of the following instructions should the nurse include? -"Discard the medication if it is cloudy." -"Briskly shake the medication before filling the syringe." -"Take this medication 15 minutes before meals." -"Eat a snack 8 hours after taking this medication."
-"Discard the medication if it is cloudy." -"Briskly shake the medication before filling the syringe." (Roll between hands to mix to prevent creating bubbles that can alter dosage.) -"Take this medication 15 minutes before meals." (Short-acting insulins, such as lispro, are taken within 15 min of meals.) -"Eat a snack 8 hours after taking this medication." (NPH insulin peaks in 6 to 14 hr after dosing. The client is at risk for hypoglycemia and might require a snack at this time. Clients should check blood glucose 8 to 10 hr after administration of NPH insulin, and if hypoglycemic, consume a small snack of 15 g of carbohydrates, followed by rechecking of the blood glucose in 15 min.) !!! A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? -Draw up the NPH insulin into the syringe first. -Inject air into the regular insulin first. -Shake the NPH insulin until it is well mixed. -Discard regular insulin that appears cloudy. -Draw up the NPH insulin into the syringe first. (actually regular insulin into the syringe first to prevent contaminating regular with NPH.) -Inject air into the regular insulin first. (actually the NPH vial first.) -Shake the NPH insulin until it is well mixed. -Discard regular insulin that appears cloudy. !!! A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? -Ranitidine -Ranitidine (Can alter serum creatinine levels, but is does not affect blood glucose levels.) -Guaifenesin (can cause drowsiness and dizziness, but does not alter blood glucose.) -Prednisone (Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.) !!! -Atorvastatin (Atorvastatin can interfere with thyroid function tests.) Do diabetic pills cause hypoglycemia?But too much insulin or other diabetes medications may cause your blood sugar level to drop too much, causing hypoglycemia. Hypoglycemia can also occur if you eat less than usual after taking your regular dose of diabetes medication, or if you exercise more than you typically do.
What is the best method of administering glipizide?Take this medication by mouth 30 minutes before breakfast or the first meal of the day as directed by your doctor, usually once daily. Some patients, especially those taking higher doses, may be directed to take this drug twice a day. The dosage is based on your medical condition and response to treatment.
When mixing the two types of insulin which of the following actions should the nurse take first?When you mix two types of insulins other than regular insulin, it does not matter in what order you draw them into the syringe. After you decide on a certain order for drawing up your insulin, you should use the same order each time. Some mixtures of insulins have to be injected immediately.
Is glimepiride better than insulin?Glimepiride plus insulin was as effective as insulin plus placebo in helping patients with secondary sulphonylurea failure to reach a fasting blood glucose target level of < or = 7.8 mmol/L, although lower insulin dosages and more rapid effects on glycaemia were seen with glimepiride.
|
A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride
zusammenhängende Posts
Urheberrechte © © 2024 ketiadaan Inc.
