A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?
"Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide
"You might need to decrease your insulin dosage while taking hydrochlorothiazide."
Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes
Reducing sodium in your die whim taking your control your blood glucose."
The Correct Answer is C
The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus.
Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.
Let's go through the other options:
A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.
B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.
D. "Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.12"]
Explanation
To calculate the rate at which the IV pump should be set to deliver dopamine, we need to determine the total amount of dopamine in the infusion and divide it by the desired dose per minute.
Given:
Dopamine concentration: 400 mg in 250 mL
Desired dose: 5 mcg/kg/min
Patient weight: 220 lb
First, we need to convert the patient's weight from pounds to kilograms:
220 lb ÷ 2.2 = 100 kg
Next, we need to calculate the total amount of dopamine needed per minute:
5 mcg/kg/min × 100 kg = 500 mcg/min
Now, we need to convert the dopamine dose from mcg to mg:
500 mcg/min ÷ 1000 = 0.5 mg/min
To determine the infusion rate in mL/hr, we divide the dose in mg/min by the dopamine concentration in the infusion solution:
0.5 mg/min ÷ 250 mL = 0.002 mL/min
Finally, we convert the infusion rate from mL/min to mL/hr by multiplying by 60:
0.002 mL/min × 60 min = 0.12 mL/hr
Therefore, the nurse should set the IV pump to deliver 0.12 mL/hr.
Correct Answer is C
Explanation
A. Urinary retention: While urinary retention can be a side effect of meperidine and other opioids, it is not the priority assessment before administering the medication. Urinary retention is a concern but is not immediately life-threatening compared to other potential side effects of opioids, such as respiratory depression. Assessing urinary retention is important, but it is not the primary concern in this situation.
B. Vomiting: Vomiting can also be a side effect of opioids, including meperidine. While it is essential to assess for vomiting and its potential impact on the client's overall condition, it is not the priority assessment before administering the medication. Vomiting can be managed, and the nurse should address it as needed. However, the priority assessment is one that can affect the client's immediate safety and well-being, such as respiratory rate and potential respiratory depression.
C. Respiratory rate: This is the correct answer. The priority assessment before administering meperidine is the client's respiratory rate. Opioids can cause respiratory depression, leading to reduced breathing and inadequate ventilation. Monitoring the respiratory rate allows the nurse to detect any signs of respiratory distress or inadequate breathing, enabling them to intervene promptly to prevent serious complications.
D. Level of consciousness: While assessing the client's level of consciousness is essential for overall assessment and monitoring, it is not the priority assessment before administering meperidine. Respiratory depression due to opioid use can occur even when the client is conscious. However, if respiratory depression occurs, it can lead to a decrease in consciousness and potentially unconsciousness, making the assessment of respiratory rate more critical to prevent such complications.
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