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Pharm diabetic evolve NCLEX ScienceMedicineNursing staci_silkwood Save EAQ Ch. 32 Diabetes Drugs 30 terms JNguyen1388Preview
Chapter 57: Drugs for Diabetes
44 terms jessica_rice71Preview Pharmacology Chapter 32 13 terms csuarez1217Preview Diabet 42 terms Fou A patient with type 1 diabetes mellitus has been ordered insulin aspart (Novolog) 10 units at 7:00 AM. What nursing intervention will the nurse perform after administering this medication?Perform a fingerstick blood sugar test.Have the patient void and dipstick the urine.Make sure the patient eats breakfast immediately.Flush the IV.Make sure the patient eats breakfast immediately.Insulin aspart (Novolog) is a rapid-acting insulin that acts in 15 minutes or less. It is imperative that the patient eat as it starts to work. The patient should have had a fingerstick blood sugar test done before receiving the medication. There is no need to check the urine. This medication is given subcutaneously.The patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine (Lantus). What information is essential for the nurse to teach this patient?This medication should be mixed with the regular insulin each morning." "This medication is very short-acting. You must be sure you eat after injecting it." "This medication is very expensive, but you will be receiving it only a short time." "This medication has a duration of action of 24 hours." "This medication has a duration of action of 24 hours." Insulin glargine (Lantus) has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas. This medication cannot be mixed with other insulins and is not a short-acting insulin. The patient may need to receive this medication for a long time.
The nurse is teaching the patient how to administer insulin. What information is essential to include in the plan?For the most consistent absorption, inject the insulin into the abdomen." "Avoid administering the insulin into your arm." "Inject the insulin at a 30-degree angle between the fat and muscle." "Do not mix any insulins in the same syringe." For the most consistent absorption, inject the insulin into the abdomen." The abdomen has the most consistent absorption because the blood flow to the subcutaneous tissue typically is not as affected by muscular movements as it could be in the arm or thigh. Insulin can be administered in the arm. The patient should be instructed to inject insulin at a 45- to 90-degree angle, not a 30-degree angle. Most insulins can be mixed.The nurse administers NPH insulin at 8 AM. What intervention is essential for the nurse to perform?Assess the patient for hyperglycemia by 10 AM.Monitor fingerstick at 2 PM.Make sure patient eats by 5 PM.Administer the insulin via IV pump Make sure patient eats by 5 PM NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia. The patient needs to eat by 5 PM.The patient would not be at high risk for hypoglycemia at 10 AM. A fingerstick is not necessary at 2 PM. The insulin should not be routinely administered IV.Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents?I will limit my alcohol consumption." "I will report symptoms of fatigue and loss of appetite." "I will take the medication only when I need it." "I will monitor my blood sugar daily." "I will take the medication only when I need it." Oral hypoglycemic agents must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes.When alcohol is ingested with certain oral hypoglycemic drugs, the hypoglycemic effect can be intensified. The patient may experience fatigue and loss of appetite as side effects of the medication, and these should be reported to the health care provider. The patient needs to closely monitor blood sugar.What information will the nurse teach the patient who has been prescribed an alpha glucosidase inhibitor?This medication will stimulate pancreatic insulin release." "This medication will increase the sensitivity of insulin receptor sites." "This medication will delay the absorption of carbohydrates from the intestines." "This medication cannot be used in combination with other antidiabetic agents." "This medication will delay the absorption of carbohydrates from the intestines." Alpha glucosidase is an enzyme necessary for the absorption of glucose from the GI tract. Inhibiting this enzyme inhibits glucose absorption, delaying rises in postprandial serum glucose levels.
The patient with type 1 diabetes mellitus asks, "Why can't I take a sulfonylurea like my friend who has diabetes?" What is the nurse's best response?"Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you." "You must be mistaken. If your friend has diabetes mellitus, she is taking insulin." "Sulfonylurea will lower your blood sugar too much, and you will be hypoglycemic." "You are unable to store glucose, because you do not have insulin, and sulfonylurea helps with glucose storage." Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you." Sulfonylurea agents reduce serum glucose levels by increasing beta-cell stimulation for insulin release, decreasing hepatic glucose production, and increasing insulin sensitivity. It is administered for type 2 diabetes mellitus but will not be effective in type 1.The nurse is teaching a patient who has been prescribed repaglinide (Prandin). Which information will the nurse include in the teaching plan?You will need to be sure you eat as soon as you take this medication." "This medication is compatible with all of your cardiac medications." "This medication will not cause hypoglycemia." "This medication has no side effects." "You will need to be sure you eat as soon as you take this medication." Repaglinide (Prandin) is short-acting. The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal. Prandin interacts with beta-adrenergic blockers as well as other medications. Hypoglycemia is a side effect of this medication, and there are many other possible side effects of this medication.Which technique is most appropriate regarding mixing insulin when the patient must administer 30 units regular insulin and 70 units NPH insulin in the morning?Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.Draw the medication into two separate syringes but inject into the same spot.Administer these insulins at least 10 minutes apart, so that you will know when they are working.Use the Z-track method for administration.Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin. The medications do not have to be in separate syringes and can be administered together. Z-track is an IM technique.The nurse would include which statement when teaching a patient about insulin glargine (Lantus)?"You should inject this insulin just before meals because it is very fast-acting." "The duration of action for this insulin is approximately 8 to 10 hours, so you will need to take it twice a day." "You can mix this insulin with Lente insulin to enhance its effects." "You cannot mix this insulin with any other insulin in the same syringe.You cannot mix this insulin with any other insulin in the same syringe." nsulin glargine (Lantus) is a long-acting insulin with a duration of action up to 24 hours. It should not be mixed with any other insulins. The insulin is not fast-acting.
Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide (Glucotrol) with food?Immediately check the patient's blood glucose level.Inform the patient that it is better to take the medication 30 minutes before a meal.Inform the patient that the medication must be taken 15 minutes after a meal.Immediately call the health care provider.Inform the patient that it is better to take the medication 30 minutes before a meal.Food inhibits the absorption of glipizide (Glucotrol), the only sulfonylurea agent that should be given 30 minutes before a meal. The blood glucose level does not have to be taken right away. The medication is not to be taken after a meal. The health care provider does not have to be called; the nurse should intervene.What is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?Administer subcutaneous regular insulin immediately.Administer glucagon.Start an insulin drip.Draw blood glucose level and send to the laboratory.Administer glucagon Glucagon stimulates glycogenolysis, raising serum glucose levels. The patient is showing signs of hypoglycemia. Terms (12) Hide definitions
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