A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Serum fasting glucose 101 mg/dL

platelets 160,000 uL

Serum creatinine 2.5 mg/dL

Hemoglobin 13.6 g/dL

Answer and Explanation

The Correct Answer is C

A.   A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B.   A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C.   A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D.   A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

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Correct Answer is A

Explanation

A. The client's fasting blood glucose levels (70-80 mg/dl) are within the normal range, and a post- prandial blood glucose level below 200 mg/dl is also considered well-controlled, particularly for someone on an intensified insulin regimen. The hemoglobin A1c level of 4.5% indicates excellent long- term glucose control, typically representing average blood glucose levels of around 90 mg/dl.
B. Hyperglycemia is characterized by elevated blood glucose levels. Given the client's consistently normal fasting and post-prandial levels, they are not at an increased risk for hyperglycemia. Instead, they are maintaining their glucose levels well.
C. Insulin resistance typically manifests as elevated blood glucose levels despite adequate insulin levels or increased insulin requirements. In this case, the client's blood glucose levels are well-controlled, indicating that they are likely responding well to insulin therapy and are not showing signs of insulin resistance.
D. While the client’s blood glucose levels are well-controlled, the risk for hypoglycemia depends on various factors, including insulin dosage, timing, and food intake. However, consistently normal levels do not directly indicate a risk for hypoglycemia unless insulin doses are excessively high or meals are skipped. Therefore, this choice is not justified given the data provided.

A. an upper urinary tract infection B. decreased caloric intake C. aerobic exercise D. clogged tubing of a subcutaneous insulin pump E. not taking sufficient insulin

Correct Answer is ["A","B","D","E"]

Explanation

A. Infections, including urinary tract infections, can increase insulin resistance and elevate blood glucose levels, potentially leading to DKA. The stress response from infection can also increase cortisol levels, further contributing to hyperglycemia.
B. Decreased caloric intake can lead to inadequate insulin levels relative to the body’s needs. In Type 1 diabetes, if insulin is not sufficient to metabolize glucose (due to low intake or other reasons), the body may resort to fat metabolism, leading to the production of ketones and the development of DKA.
C. While exercise can affect blood glucose levels, it typically lowers them and is not a direct cause of DKA. In fact, moderate aerobic exercise is usually encouraged for managing diabetes. However, if blood glucose levels are already high before exercise, it may exacerbate the situation, but aerobic exercise itself is not a cause of DKA.
D. Clogged tubing can prevent insulin delivery, leading to insufficient insulin levels. This lack of insulin can result in elevated blood glucose levels and, ultimately, the risk of DKA if not addressed.
E. Not taking enough insulin is a primary cause of DKA in Type 1 diabetes. Without adequate insulin, the body cannot utilize glucose properly, leading to increased fat metabolism and the production of ketones, which can cause DKA.

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A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client, on an intensified insulin regimen, consistently has a fasting blood glucose between 70 and 80 mg/dl, a post prandial blood glucose level below 200 mg/dl, and a hemoglobin A1c level of 4.5%. What is the nurse's interpretation of these findings? The client is:

Correct Answer is A

Explanation

The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D","E"]

Explanation

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