A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus to be used at home. When should the nurse instruct the client and family that glucagon needs to be administered?

At the onset of signs of diabetic ketoacidosis.

Before meals to prevent hyperglycemia.

When unable to eat during sick days.

When signs of severe hypoglycemia occur.

Answer and Explanation

The Correct Answer is D

Choice A reason: Diabetic ketoacidosis is a complication of diabetes that occurs when the body produces high levels of ketones due to lack of insulin. Glucagon is not indicated for this condition, as it would increase the blood glucose level even more. The nurse should instruct the client and family to monitor the blood glucose and ketone levels, administer insulin as prescribed, and seek medical attention if the condition worsens.

Choice B reason: Glucagon is not used to prevent hyperglycemia, which is a high blood glucose level. Glucagon is a hormone that raises the blood glucose level by stimulating the breakdown of glycogen in the liver. The nurse should instruct the client and family to prevent hyperglycemia by following a balanced diet, taking insulin as prescribed, and exercising regularly.

Choice C reason: Glucagon is not used when the client is unable to eat during sick days, unless the client has signs of hypoglycemia, which is a low blood glucose level. Glucagon is used as a last resort when the client is unconscious or unable to swallow. The nurse should instruct the client and family to follow the sick day rules, which include monitoring the blood glucose and urine ketone levels, taking insulin as prescribed, drinking fluids, and eating small amounts of carbohydrates.

Choice D reason: Glucagon is used when the client has signs of severe hypoglycemia, such as confusion, seizures, or loss of consciousness. Glucagon is injected subcutaneously or intramuscularly by a family member or a caregiver to raise the blood glucose level quickly. The nurse should instruct the client and family to recognize the signs of hypoglycemia, treat mild to moderate hypoglycemia with oral glucose, and call 911 after administering glucagon.

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Correct Answer is C

Explanation

Choice A reason: This is not the laboratory finding that indicates that the medication has been effective. Serum ammonia level of 30 Mcg/dL (17.62 mmol/L) is within the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate is a cation-exchange resin that binds to potassium in the intestine and removes it from the body through the stool. It does not affect the ammonia levels in the blood, which are influenced by the liver function and the urea cycle. The nurse should monitor the ammonia levels for any changes, but it is not the goal of the medication.

Choice B reason: This is not the laboratory finding that indicates that the medication has been effective. Hemoglobin level of 13.5 g/dL (135 g/L) is within the normal range for females, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the hemoglobin levels in the blood, which are determined by the number and size of red blood cells and the oxygen-carrying capacity of the blood. The nurse should monitor the hemoglobin levels for any changes, but it is not the goal of the medication.

Choice C reason: This is the laboratory finding that indicates that the medication has been effective. Serum potassium level of 3.8 mEq/L (3.8 mmol/L) is within the normal range for adults, and it indicates that the medication has lowered the potassium levels in the blood. Sodium polystyrene sulfonate is used to treat hyperkalemia, or high potassium levels, which can occur in AKI due to the impaired renal excretion of potassium. Hyperkalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. The nurse should administer sodium polystyrene sulfonate as prescribed and check the serum potassium levels regularly to ensure that they are within the normal range.

Choice D reason: This is not the laboratory finding that indicates that the medication has been effective. Serum glucose level of 120 mg/dL (6.7 mmol/L) is slightly above the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the glucose levels in the blood, which are influenced by the carbohydrate metabolism and the insulin secretion and action. The nurse should monitor the glucose levels for any changes, but it is not the goal of the medication.

A. Take the medication an hour after antacids. B. Notify the healthcare provider of lethargy. C. Decrease cigarette use to a pack per day. D. Monitor for any signs of sexual dysfunction. E. None F. None

Correct Answer is C

Explanation

Choice A reason: Antacids can interfere with the absorption of cimetidine. It is generally recommended to avoid taking antacids within 1 hour before or after taking cimetidine to ensure optimal absorption. Therefore, taking cimetidine an hour after antacids is appropriate.

Choice B reason: Notifying the healthcare provider of lethargy is a correct statement, as it may indicate a serious side effect of cimetidine. Cimetidine can cause central nervous system effects, such as confusion, drowsiness, headache, and depression. Lethargy may also be a sign of anemia, which is another possible side effect of cimetidine. The nurse should instruct the client to report any unusual symptoms to the healthcare provider and monitor the client's blood count and liver function.

Choice C reason:Smoking has been shown to impair the effectiveness of cimetidine in treating ulcers and can delay healing. The goal should be complete smoking cessation rather than merely reducing cigarette use. Therefore, the statement about decreasing cigarette use to a pack per day indicates a misunderstanding and requires additional instruction by the nurse.

Choice D reason: Monitoring for any signs of sexual dysfunction is a correct statement, as it may indicate another side effect of cimetidine. Cimetidine can cause endocrine effects, such as gynecomastia, impotence, and decreased libido in men, and menstrual irregularities in women. The nurse should instruct the client to inform the healthcare provider if they experience any changes in their sexual function or reproductive health.

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A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus to be used at home. When should the nurse instruct the client and family that glucagon needs to be administered?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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