A client with type 2 diabetes mellitus who takes glimepiride PO daily calls the nurse to report a recent onset of nausea, vomiting, and diarrhea. Which response should the nurse provide?

Use insulin sliding scale until symptoms are resolved.

Return to the clinic for laboratory tests for an infection.

Schedule a visit for evaluation by the healthcare provider (HCP).

Increase oral fluid intake until these symptoms subside.

Answer and Explanation

The Correct Answer is C

A. Use insulin sliding scale until symptoms are resolved: Starting insulin without an evaluation would be inappropriate. A sliding scale may eventually be needed if blood sugars fluctuate, but the priority is to assess the cause of the gastrointestinal symptoms first.

B. Return to the clinic for laboratory tests for an infection: Although an infection could be a cause, nausea, vomiting, and diarrhea in a diabetic client also raise concern for possible medication issues, dehydration, or even metabolic disturbances. Immediate evaluation is necessary before simply ordering lab tests.

C. Schedule a visit for evaluation by the healthcare provider (HCP): New gastrointestinal symptoms could indicate a significant underlying issue such as medication intolerance, dehydration, or even diabetic ketoacidosis (though less common in type 2). An urgent clinical assessment by the HCP is most appropriate.

D. Increase oral fluid intake until these symptoms subside: While staying hydrated is important, advising fluids alone without a thorough assessment risks missing a serious underlying cause. Symptom management should not replace a proper medical evaluation.

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Free Nursing Study Resources

Correct Answer is ["B","C","D","F"]

Explanation

A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.

B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.

C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.

D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.

E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.

F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.

A. Blood glucose 218 mg/dL (12.1 mmol/L) B. Dizziness while sitting up C. Blood pressure 162/111 mm Hg D. Pain rated at 1 on a 0 to 10 scale E. Urine output 600 mL

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"C"}}

Explanation

Blood glucose 218 mg/dL (12.1 mmol/L)

Classification: Unrelated Finding
Rationale: Minoxidil does not influence blood glucose levels. This elevated blood glucose is likely related to the patient’s known history of type 2 diabetes mellitus. It's not a side effect or intended therapeutic action of minoxidil.

Dizziness while sitting up

Classification: Nontherapeutic Side Effect
Rationale: Minoxidil is a vasodilator that can cause a rapid drop in blood pressure, particularly when changing positions (orthostatic hypotension). Dizziness is a common side effect due to decreased cerebral perfusion when blood pressure drops too quickly or too much.

Blood pressure 162/111 mm Hg

Classification: Therapeutic Result
Rationale: On admission, the patient’s BP was dangerously high at 203/166 mm Hg. A subsequent reading of 162/111 mm Hg shows a significant drop, indicating that minoxidil is having the desired therapeutic effect of lowering blood pressure, even though it's still above target.

Pain rated at 1 on a 0 to 10 scale

Classification: Unrelated Finding
Rationale: Minoxidil is not a pain medication and does not impact pain perception. A low pain score of 1 is likely due to an unrelated mild discomfort or pre-existing condition and has no connection to minoxidil's effects.

Urine output 600 mL

Classification: Unrelated Finding
Rationale: Minoxidil may cause fluid retention, but 600 mL urine output is within the normal range over a few hours (depending on timing and context). This measurement alone does not indicate a therapeutic or side effect of the drug, and without signs of oliguria or diuresis, it remains unrelated.

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A client with type 2 diabetes mellitus who takes glimepiride PO daily calls the nurse to report a recent onset of nausea, vomiting, and diarrhea. Which response should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Correct Answer is ["B","C","D","F"]

Explanation

Patient Data Exhibits Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"C"}}

Explanation

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

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