The nurse is caring for a client with type 2 diabetes mellitus who is taking liraglutide. Which problem(s) in the client's history may increase the risk for development of pancreatitis? Select all that apply.
High triglyceride levels.
Chronic alcohol use.
Gallstones.
Moderate daily alcohol use.
Pancreatitis.
Correct Answer : A,B,C,E
Rationale:
A. High triglyceride levels: Elevated triglycerides are a major risk factor for pancreatitis because they can cause pancreatic inflammation by leading to the accumulation of free fatty acids that injure pancreatic tissue. Clients with uncontrolled lipid levels require close monitoring while on medications like liraglutide.
B. Chronic alcohol use: Long-term alcohol consumption damages the pancreas directly by promoting inflammation and fibrosis, significantly increasing the risk of pancreatitis. Chronic use compounds the pancreatitis risk when the client is also taking medications like liraglutide that carry a pancreatic warning.
C. Gallstones: Gallstones can obstruct the pancreatic duct, leading to the backflow of digestive enzymes and resulting in pancreatic inflammation. A history of gallstones makes the client particularly vulnerable to developing pancreatitis while on incretin-based therapies like liraglutide.
D. Moderate daily alcohol use: Moderate alcohol intake is less strongly associated with pancreatitis compared to heavy or chronic use. Although any alcohol use can pose some risk, moderate consumption alone is generally not considered a primary risk factor for drug-induced pancreatitis.
E. Pancreatitis: A personal history of pancreatitis indicates previous pancreatic injury, making the pancreas more susceptible to future episodes. Starting liraglutide in someone with a history of pancreatitis requires extreme caution due to the increased likelihood of recurrence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Reassure the client that the patch will begin to take effect within a few minutes: Transdermal nitroglycerin provides a slow, continuous release of medication and is not designed to treat acute chest pain. Relying on the patch alone could delay urgently needed relief for ischemic pain.
B. Withhold further doses of nitroglycerin until contacting the healthcare provider: Sublingual nitroglycerin is prescribed specifically for immediate relief of anginal pain. Waiting for provider instructions before addressing active chest pain would not follow standard angina protocols and could endanger the client.
C. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: In cases of acute chest pain, it is appropriate to maintain the transdermal patch for background therapy and give sublingual nitroglycerin for immediate relief. Sublingual forms act rapidly by dilating coronary arteries and improving blood flow to relieve ischemia.
D. Obtain another transdermal patch and position it on the client's left upper chest: Applying an additional transdermal patch is inappropriate and could result in overdose, severe hypotension and will not provide immediate relief. The onset of action for transdermal nitroglycerin is too slow to address acute chest pain. The focus should be on a rapid-acting form of nitroglycerin.
Correct Answer is ["A","D","G"]
Explanation
A. Nausea: Morphine commonly causes nausea, which can lead to dizziness and unsteadiness when standing or moving. This increases the client’s risk of falls, especially when transitioning from bed to chair or ambulating postoperatively.
B. Euphoria: While morphine may cause a sensation of euphoria, this emotional effect alone does not directly contribute to physical instability or fall risk in the immediate postoperative period.
C. Itching: Itching is a common side effect of opioids but does not impair balance or mobility directly, so it is not a significant contributor to fall risk.
D. Orthostatic hypotension: Morphine can cause vasodilation, leading to drops in blood pressure when moving from lying to sitting or standing. Orthostatic hypotension can result in lightheadedness or fainting, sharply increasing the risk of falls.
E. Seizures: Seizures are rare side effects of morphine, typically associated with very high doses or toxicity. They are not in standard therapeutic use to be considered a primary fall risk factor.
F. Urinary retention: Urinary retention is a side effect of morphine but does not directly cause instability or contribute to falls unless it leads to urgency and hurried movement, which is less typical.
G. Sedation: Sedation is one of the most significant opioid side effects contributing to falls. Reduced alertness and slower reflexes make it much harder for clients to safely ambulate or protect themselves from falls.
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