The nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L) Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take?

Reference Range:

Glucose [74 to 106 mg/dl. (4.1 to 5.9 mmol/L)]

Administer the medication

Notify the healthcare provider.

Hold the medication until the meal trays arrive.

Obtain another finger tick blood glucose level.

Answer and Explanation

The Correct Answer is C

A. Administer the medication: Acarbose is an alpha-glucosidase inhibitor that should be taken with the first bite of a meal to effectively manage postprandial blood glucose levels. Administering it before the meal is inappropriate as it can lead to inadequate glucose control.
B. Notify the healthcare provider: While notifying the healthcare provider might be necessary if there are significant issues, it is not the immediate action needed in this situation. The priority is to manage the timing of the medication relative to the meal.
C. Hold the medication until the meal trays arrive: Acarbose should be taken with food to work effectively in controlling blood glucose levels after meals. If the meal is delayed, the medication should be held until the meal is ready to ensure proper administration.
D. Obtain another finger stick blood glucose level: Rechecking the blood glucose level does not address the issue of the timing of the acarbose administration. The focus should be on ensuring the medication is taken with the meal.

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Correct Answer is D

Explanation

A. Determine if there is a decrease in serum potassium due to renal compromise: Acetaminophen is not commonly associated with significant renal impairment or changes in serum potassium levels, making this a less relevant consideration.
B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding: Acetaminophen does not significantly affect APTT or bleeding risk, so changes in APTT would not be expected due to acetaminophen use.
C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration: Acetaminophen is not known to cause changes in hemoglobin and hematocrit levels or dehydration-related increases in these values.
D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage: Acetaminophen overdose or chronic high use can lead to liver damage, which would be indicated by elevated LDH levels. Monitoring LDH is appropriate to assess for potential liver damage related to acetaminophen use.

A. Determine if the client is taking the medication before meals. B. Ask if his morning voiding is dark colored. C. Explore what the client means by the drug not working. D. Evaluate the client for signs of dyskinesia.

Correct Answer is C

Explanation

A) Determine if the client is taking the medication before meals: While the timing of medication relative to meals can affect absorption, this action assumes a specific problem without first clarifying the client's concerns. It's important to understand the nature of the client's issue before assessing medication administration.
B) Ask if his morning voiding is dark colored: Dark-colored urine may be a side effect of some medications, but this is a less direct approach to understanding why the client feels the medication is not working. It does not directly address the effectiveness of the medication.
C) Explore what the client means by the drug not working: This is the most appropriate initial intervention. Understanding the client's perception and specific concerns about the medication's effectiveness will guide further actions, such as assessing medication adherence, side effects, or the need for a medication adjustment.

D) Evaluate the client for signs of dyskinesia: While assessing for dyskinesia is important, it is more of a specific follow-up step. The priority is to understand the client's concerns about the medication's overall effectiveness before focusing on specific side effects.

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