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.

Answer and Explanation

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.

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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.

A. Observe the client's mucous membranes. B. Auscultate the client's bowel sounds. C. Assess the client's level of consciousness (LOC). D. Record the client's urinary output.

Correct Answer is C

Explanation

A. Observe the client's mucous membranes: Monitoring mucous membranes is useful for assessing hydration status, but it is not the most critical intervention related to fentanyl use. The primary concern with opioid administration, especially fentanyl, is central nervous system and respiratory depression.

B. Auscultate the client's bowel sounds: Opioids like fentanyl can cause constipation due to slowed gastrointestinal motility. Although monitoring bowel sounds is important, it is a secondary concern compared to the immediate need to assess neurological and respiratory status.

C. Assess the client's level of consciousness (LOC): Fentanyl, a potent opioid, poses a significant risk for sedation and respiratory depression. Regular assessment of the client's LOC is essential to detect early signs of opioid toxicity, such as excessive drowsiness, confusion, or unresponsiveness, allowing for prompt intervention.

D. Record the client's urinary output: Opioids can lead to urinary retention, making output monitoring necessary, but it is not the most urgent priority. Ensuring the client's neurological status and breathing are stable takes precedence when administering potent opioids like fentanyl.

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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.

Nursing Test Bank

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Correct Answer is ["A","D","G"]

Explanation

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Correct Answer is C

Explanation

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