A nurse is preparing to administer medications to a client who has type 1 diabetes mellitus. The client takes lispro insulin and has a new prescription for pramlintide. Which of the following actions should the nurse take?
Monitor the client for weight gain.
Monitor for hypoglycemia for 3 hr after pramlintide administration.
Inject the pramlintide in the client’s upper arm.
Administer pramlintide 30 min prior to a meal.
The Correct Answer is B
Choice A rationale
Monitoring for weight gain is not a primary concern with pramlintide. Pramlintide is an amylin analog used to control postprandial blood glucose levels. Weight gain is not a typical side effect of pramlintide; instead, it may cause weight loss due to its effects on appetite suppression and delayed gastric emptying.
Choice B rationale
Monitoring for hypoglycemia for 3 hours after pramlintide administration is crucial. Pramlintide can increase the risk of insulin-induced hypoglycemia, especially in patients with type 1 diabetes. This is because pramlintide slows gastric emptying and suppresses glucagon secretion, which can lead to lower blood glucose levels.
Choice C rationale
Injecting pramlintide in the upper arm is not recommended. Pramlintide should be administered subcutaneously in the abdomen or thigh, not the upper arm, to ensure proper absorption and effectiveness.
Choice D rationale
Administering pramlintide 30 minutes prior to a meal is incorrect. Pramlintide should be administered immediately before meals to help control postprandial blood glucose levels effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
The nurse should first address the client’s oxygen saturation, followed by the client’s blood pressure.
Addressing the oxygen saturation is crucial because the client’s level has dropped significantly to 86%, indicating potential respiratory distress or hypoxia. Following that, the nurse should address the blood pressure, which has also dropped, indicating possible hemodynamic instability.
Let’s break down the case notes to understand why addressing the client’s oxygen saturation and blood pressure is critical:
Oxygen Saturation
- Initial Vital Signs (1200): The client’s oxygen saturation was 100% on 2 L oxygen via nasal cannula.
- Current Vital Signs (1220): The oxygen saturation has dropped to 86% on the same oxygen support.
This significant drop in oxygen saturation indicates that the client is not receiving adequate oxygen, which can lead to hypoxia. Hypoxia can cause severe complications, including organ damage. Therefore, improving oxygenation is the top priority.
Blood Pressure
- Initial Vital Signs (1200): The client’s blood pressure was 110/75 mm Hg.
- Current Vital Signs (1220): The blood pressure has decreased to 90/60 mm Hg.
The drop in blood pressure suggests that the client is experiencing hemodynamic instability, which could be due to several factors, including dehydration, blood loss, or a reaction to anesthesia. Low blood pressure can lead to inadequate perfusion of vital organs, which is why it needs to be addressed promptly after stabilizing the oxygen saturation.
Other Symptoms
- Muscle Rigidity: The client is experiencing painful muscle rigidity, which could be a sign of a serious condition like malignant hyperthermia, especially given the elevated temperature.
- Temperature: The client’s temperature has spiked to 40.2°C (104.4°F), indicating a possible infection or reaction.
- Heart Rate: The heart rate has increased to 125/min, which could be a compensatory response to low blood pressure and hypoxia.
- Nausea and Vomiting: The client has vomited twice, which could contribute to dehydration and electrolyte imbalance.
Conclusion
By addressing the oxygen saturation first, the nurse ensures that the client is receiving adequate oxygen, which is essential for all bodily functions. Following that, stabilizing the blood pressure is crucial to ensure proper perfusion and prevent further complications.
Correct Answer is ["A","F"]
Explanation
Choice A rationale
Thrombocytopenia, a low platelet count, increases the risk of bleeding and hemorrhage when receiving heparin.
Choice B rationale
Neutropenia, a low white blood cell count, does not directly increase the risk of hemorrhage. It is more related to infection risk.
Choice C rationale
Hypokalemia, low potassium levels, does not directly indicate a risk for hemorrhage. It can cause other complications but not specifically bleeding.
Choice D rationale
Fever is not a direct indicator of hemorrhage risk. It may indicate infection or other inflammatory processes.
Choice E rationale
Hyperglycemia, high blood sugar levels, does not indicate a risk for hemorrhage. It is more related to diabetes management.
Choice F rationale
Dark stools can indicate gastrointestinal bleeding, which is a sign of hemorrhage.
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