summer exam 2

Question 1

which types of medications are indicated for type 1 DM

Answer 1

insulin

Question 2

which types of medications are indicated for type 2 DM

Answer 2

diet, oral agents &/or insulin

Question 3

which types of medications are indicated for gestational diabetes

Answer 3

-dietary control is initial management
-insulin can be safely during pregnancy and after delivery

Question 4

which types of medications are contraindicated for gestational diabetes pts

Answer 4

oral DM meds

Question 5

what laboratory test is the best indicator of a client’s average blood sugar?

Answer 5

Hgb A1C- measures average BG over 8-12 weeks

Question 6

diabetes Hgb A1C %

Answer 6

> 6.5%

Question 7

steps to mixing insulin

Answer 7

1. roll cloudy insulin in palms to mix
2. clean tops of vials
3. inject air into cloudy
4. inject air into clear
5. inject clear
6. inject cloudy

Question 8

which insulins are safe to mix in the same syringe?

Answer 8

anything except glargine (Lantus)

Question 9

what effects can occur to breast milk when administering insulin?

Answer 9

decreases mother’s supply when using insulin

Question 10

glyburide is a ____. therefore, a client with a ____ allergy should not take this medication.

Answer 10

• sulfonylurea
• sulfa

Question 11

what additional education should a nurse provide to a client about taking glyburide?

Answer 11

take 30 mins prior to meals to ensure it has absorbed prior to intake of food

Question 12

metformin works on the ____ to decrease ____ production from the liver and to decrease ____ ____ of glucose.

Answer 12

• glucose
• intestinal absorption

Question 13

metformin also decreases insulin ____ in metabolic syndrome.

Answer 13

resistance

Question 14

pioglitazone works to decrease insulin ____

Answer 14

resistance

Question 15

clients with a history of ____ ____ should not take pioglitazone.

Answer 15

CHF or pulmonary edema

Question 16

how would a nurse know a client has a potential adverse cardiac issue requiring intervention while taking pioglitazone?

Answer 16

weight gain = immediate evaluation by PCP

Question 17

mimetics work by. . .

Answer 17

mimicking the the incretin hormones, which normally tell your body to release insulin secretion from the beta cells of the pancreas and suppress glucagon

Question 18

glucagon increase blood glucose by. . .

Answer 18

stimulating glycogenolysis

Question 19

how can glucagon be administered?

Answer 19

IVP, IM, subq

Question 20

antacids promote secretion of protective defenses in what ways?

Answer 20

mucus- protective barrier against HCL
bicarbonate- helps buffer acidic properties of HCL

Question 21

what are the adverse effects of a magnesium antacid?

Answer 21

diarrhea

Question 22

which acid-base imbalance might occur with magnesium antacids?

Answer 22

• magnesium accumulation
  -dangerous when used with renal failure- failing kidney cannot excrete extra magnesium, causing accumulation

Question 23

what are the adverse effects of sodium bicarbonate antacid?

Answer 23

• metabolic alkalosis
• sodium content may cause increase in fluid retention with HF, HTN, or renal insufficiency

Question 24

what acid-base imbalance might occur with sodium bicarbonate antacids?

Answer 24

• metabolic alkalosis with long-term or excess use

Question 25

what side effects should a nurse be aware of when a client is taking a calcium antacid?

Answer 25

-may cause constipation and kidney stones -long duration of acid action- may cause rebound hyperacidity

Question 26

when educating client about proton pump inhibitors, they should be instructed to not ____ the capsule and the medication will take ____ to ____ weeks to be fully ____.

Answer 26

- crush - 6, 8 - effective

Question 27

what is a potential effect from long-term use of a proton pump inhibitor

Answer 27

may impair B12 absorption, causing pernicious anemia

Question 28

ondansetron is commonly used for ____ in the post-operative phase and for nausea associated with the administration of ____.

Answer 28

- n/v - chemotherapy

Question 29

a client has been nauseated and receiving medication to relieve this symptom post operatively. the client begins exhibiting EPS such as lip smacking. what medication has the client most likely been receiving for nausea?

Answer 29

promethazine (Phernergan)

Question 30

what are the other s/s of EPS the client might start exhibiting?

Answer 30

twitching, lip smacking, grimacing, tremors, eye blinking

Question 31

sulfasalazine is newly prescribed to a 15 year old client. what should be included in the teaching for the client and the parent?

Answer 31

- take in divided doses to decrease adverse effecta - take on an empty stomach - drink a lot of water while taking to prevent crystalluria - wear long sleeves when exposed to sunlight d/t photosensitivity - may increase risk of hypoglycemia

Question 32

insulin lispro (Humalog), insulin aspart (NovoLog) onset, peak, duration

Answer 32

- o: 15 min - p: 1-2 hr - d: 3-5 hr

Question 33

regular insulin (Humulin R or Novolin R) onset, peak, duration

Answer 33

- o: 30-60 min - p: 2.5 hr - d: 6-10 hr

Question 34

isophane insulin suspension (NPH) onset, peak, duration

Answer 34

- o: 1-2 hr - p: 4-8 hr - d: 10-18 hr

Question 35

glargine (Lantus) onset, peak, duration

Answer 35

- o: 1-2 hr - p: no peak - d: 24 hr

Question 36

detemir (Levemir) onset, peak, duration

Answer 36

- o: 1-2 hr - p: 3-14 hr - d: 24 hr

Question 37

rapid-acting insulin

Answer 37

insulin lispro (Humalog), insulin aspart (NovoLog)

Question 38

short-acting insulin

Answer 38

regular insulin (Humulin R or Novolin R)

Question 39

intermediate-acting insulin

Answer 39

isophane insulin suspension (NPH)

Question 40

long-acting insulin

Answer 40

glargine (Lantus), detemir (Levemir)

Question 41

insulin mix

Answer 41

Humulin 70/30, Novolog 70/30

Question 42

glucophage (Metformin) class

Answer 42

biguanide

Question 43

pioglitazone (Actos) class

Answer 43

thiazolidinediones

Question 44

sitagliptin (Januvia), exenatide (Byetta) class

Answer 44

incretin enhancers: mimetics

Question 45

which DM oral medication helps with weight control/how?

Answer 45

- sitagliptin (Januvia), exenatide (Byetta)- MIMETICS - by increasing feeling of satiety