A patient with type 2 diabetes is prescribed glipizide (Glucotrol) 10 mg orally before meals.
The patient inquires, “What is the mechanism of action of this medication in managing my diabetes?” How should the nurse respond?
It enhances glucose transport into the muscles.
It facilitates glucose utilization by body cells.
It boosts glucose levels to provide more energy to the body.
It triggers beta cells in the pancreas to release insulin, thereby reducing blood glucose levels.
The Correct Answer is D
Choice A rationale:
Glipizide does not directly enhance glucose transport into the muscles. This action is primarily mediated by insulin, which increases the expression of glucose transporter proteins (GLUT4) on muscle cell membranes, facilitating glucose uptake.
While glipizide can indirectly improve glucose transport into muscles by increasing insulin levels, it's not the primary mechanism of action.
Choice B rationale:
Glipizide does not directly facilitate glucose utilization by body cells. This process also largely depends on insulin, which activates intracellular pathways that promote glucose metabolism and energy production.
Although glipizide can indirectly enhance glucose utilization by increasing insulin availability, it's not the main mechanism responsible for its glucose-lowering effects.
Choice C rationale:
Glipizide does not boost glucose levels. In fact, it has the opposite effect, lowering blood glucose levels by stimulating insulin secretion.
Elevating glucose levels would be counterproductive in diabetes management, as the goal is to maintain blood glucose within a healthy range.
Choice D rationale (correct answer):
Glipizide belongs to a class of medications called sulfonylureas, which act primarily by stimulating insulin secretion from pancreatic beta cells.
Insulin is a hormone that plays a crucial role in regulating blood glucose levels. It promotes glucose uptake by various tissues, including muscles, liver, and adipose tissue, and it inhibits glucose production by the liver.
By triggering insulin release, glipizide effectively lowers blood glucose levels. This helps to prevent the long-term complications of diabetes, such as damage to blood vessels, nerves, and organs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:
Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.
Correct Answer is C
Explanation
Rationale for Choice A:
Decreasing the morning insulin dose by half without consulting the provider could lead to hyperglycemia, which can be dangerous for patients with diabetes, especially those undergoing surgery.
It is important to individualize insulin doses based on the patient's blood glucose levels, insulin sensitivity, and other factors. The provider may need to assess the patient's blood glucose levels and adjust the insulin dose accordingly.
Rationale for Choice B:
It is not safe to assume that the provider would want the client to receive the usual insulin dose prior to surgery without confirming this with the provider.
Patients with diabetes who are NPO (nothing by mouth) are at risk for hypoglycemia, as they are not receiving their usual intake of carbohydrates.
It is important to adjust insulin doses to prevent hypoglycemia in these patients.
Rationale for Choice D:
Holding the morning dose of insulin until after a fasting glucose is done could lead to hyperglycemia, as the patient would not be receiving any insulin to cover their blood glucose levels.
It is important to administer insulin to patients with diabetes, even if they are NPO, to prevent hyperglycemia.
Rationale for Choice C:
This is the best action for the nurse to take because it ensures that the provider is aware of the situation and can provide appropriate orders for the patient's insulin management.
The provider may need to adjust the insulin dose, order a fasting glucose level, or provide other instructions for the patient's care.
It is important to communicate with the provider to ensure that the patient receives safe and appropriate care.
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