A patient with type 1 diabetes has a high morning glucose measurement and the healthcare provider wants the patient evaluated for possible Somogyi effect. The nurse will plan to
obtain the patient's blood glucose level between 2a.m-4a.m
check the patient for a change in level of consciousness between 2a.m-4a.m
withhold the night time snack and check the glucose at 6:00a.m.
administer an increased dose of NPH insulin in the evening
The Correct Answer is A
A. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.
B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.
C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.
D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Avoid alcoholic beverages. – Correct Answer. Alcohol can lower the seizure threshold and interfere with antiepileptic medications.
B. Take tub baths instead of showers. – Incorrect. Showers are safer because a seizure in a bathtub increases the risk of drowning.
C. When the seizures stop, discontinue the medication. – Incorrect. Antiepileptic drugs should not be stopped abruptly, even if seizures are well controlled.
D. Continue to take OTC medications as needed. – Incorrect. Some OTC medications can interact with antiepileptic drugs, so a healthcare provider should be consulted before use.
Correct Answer is B
Explanation
A. Infuse the transfusion at a rate of 200 mL/hr. – Incorrect. The initial infusion should be slow (e.g., 75-100 mL/hr) to monitor for reactions.
B. Check the patient's vital signs every hour during the transfusion. – Correct Answer. Frequent monitoring is necessary to detect adverse reactions, such as fever or hypotension.
C. Leave the patient 5 minutes after beginning the transfusion. – Incorrect. The nurse should remain with the patient for the first 15 minutes, as most transfusion reactions occur early.
D. Flush the blood tubing with dextrose 5% in water. – Incorrect. Only normal saline should be used to flush blood tubing, as dextrose can cause hemolysis.
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