The nurse is teaching a client who has been prescribed sitagliptin (Januvia) for type 2 diabetes. Which statement by the client indicates a need for further teaching?

“This medication helps lower my blood sugar by increasing insulin release."

"I need to keep monitoring my blood sugar regularly while on this medication."

"I will call my provider if I develop severe abdominal pain that doesn't go away."

"If I feel nauseated or vomit after taking this drug, I should just wait and see if it gets better."

Answer and Explanation

The Correct Answer is D

A. “This medication helps lower my blood sugar by increasing insulin release.": Sitagliptin (Januvia) works by increasing insulin release and decreasing glucagon levels when blood glucose is elevated, helping to lower blood sugar.

B. "I need to keep monitoring my blood sugar regularly while on this medication.": Regular monitoring of blood glucose levels is important to ensure the medication is working effectively and to detect any changes in blood sugar.

C. "I will call my provider if I develop severe abdominal pain that doesn't go away.": Severe abdominal pain can be a sign of a serious side effect such as pancreatitis, and the client should contact their healthcare provider immediately if this occurs.

D. "If I feel nauseated or vomit after taking this drug, I should just wait and see if it gets better.": Nausea and vomiting can be side effects of sitagliptin. If the client experiences these symptoms, they should not simply wait, but instead contact their provider for further guidance, as these symptoms may require adjustments to the treatment plan.

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Correct Answer is D

Explanation

A. Hyperglycemia occurring on "sick days": Glucagon is not used to treat hyperglycemia. During "sick days," clients with diabetes may experience elevated blood glucose levels, but glucagon is not for managing hyperglycemia. Instead, insulin adjustments are made.

B. Diabetic ketoacidosis: Glucagon is not used to treat diabetic ketoacidosis (DKA). DKA is a severe complication of diabetes often caused by insulin deficiency, and it requires insulin therapy and fluid management to correct the underlying issues.

C. Hyperglycemia from insufficient insulin: Glucagon is not used for hyperglycemia due to insufficient insulin. The treatment for this condition is typically insulin therapy to lower blood glucose levels.

D. Hypoglycemia from insulin overdose: Glucagon is used to treat hypoglycemia caused by an insulin overdose, as it helps to raise blood glucose levels quickly by stimulating the liver to release glucose into the bloodstream. It is essential for managing severe hypoglycemia.

A. notify the night supervisor of the patient's deteriorating condition. B. give 4 ounces of orange juice, wait 15 minutes and re-check the capillary blood sugar, followed by 15g of a complex carbohydrate with a protein, such as wheat bread peanut butter. C. ambulate the patient in the hall to use up excess glucose with exercise. D. give insulin by sliding scale based on glucometer reading.

Correct Answer is B

Explanation

A. Notify the night supervisor of the patient's deteriorating condition: While it’s important to keep supervisors informed, hypoglycemia needs to be treated immediately. The priority action is to raise the patient’s blood glucose level, not waiting to notify the supervisor.

B. The patient is experiencing symptoms of hypoglycemia, and the best initial action is to give a fast-acting carbohydrate like orange juice (about 15g of sugar). After 15 minutes, the blood sugar should be rechecked. Following the treatment with a complex carbohydrate and protein helps to maintain blood glucose levels and prevent recurrence of hypoglycemia.

C. Ambulate the patient in the hall to use up excess glucose with exercise: Exercise can lower blood glucose levels, which would be dangerous in a hypoglycemic patient. The priority is to raise the blood sugar rather than use exercise to manage glucose levels.

D. Give insulin by sliding scale based on glucometer reading: The patient’s blood sugar is low (51 mg/dL), which indicates hypoglycemia, not hyperglycemia. Insulin should not be administered in this situation, as it would further decrease the blood glucose levels.

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The nurse is teaching a client who has been prescribed sitagliptin (Januvia) for type 2 diabetes. Which statement by the client indicates a need for further teaching?

Nursing Test Bank

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