Which medical condition would warrant a prescription for high-dose corticosteroids?

Choice A rationale:

Regular insulin peaks within 2-4 hours after administration. Therefore, to prevent hypoglycemia due to the insulin administered at 0700, the client should eat breakfast within 1-2 hours of insulin administration. This will ensure that there is glucose available in the bloodstream to match the insulin's action and prevent blood sugar levels from dropping too low.

Breakfast is the most important meal of the day, especially for individuals with diabetes. It helps to regulate blood sugar levels throughout the morning and can even help with weight management and overall health.

Skipping breakfast can lead to fluctuations in blood sugar levels and increase the risk of hypoglycemia, especially after insulin administration.

Choice B rationale:

Supper, typically consumed in the evening, would not be timely enough to prevent hypoglycemia due to the 0700 insulin administration. The insulin's peak action would have already subsided by that time, and the client would be at risk for hyperglycemia (high blood sugar) instead.

Choice C rationale:

Lunch, typically consumed around noon, would also be too late to prevent hypoglycemia from the 0700 insulin administration. The insulin's peak action would have already passed, and the client would be more likely to experience hyperglycemia.

Choice D rationale:

A snack, while it can provide some glucose, is not a substitute for a balanced meal like breakfast. Snacks often contain less protein and fiber, which are essential for slowing down glucose absorption and maintaining blood sugar stability. Relying solely on snacks to prevent hypoglycemia is not a reliable strategy for long-term blood sugar management.

Choice A rationale:

Insulin glargine (Lantus) is a long-acting insulin that does not have any immediate effect on blood glucose levels. It is not typically a concern for patients undergoing CT scans with contrast.

However, it is important to monitor blood glucose levels closely in patients with diabetes who are receiving insulin therapy, as the contrast media used in CT scans can sometimes cause hyperglycemia.

Choice B rationale:

Acarbose (Precose) is an alpha-glucosidase inhibitor that works by slowing the absorption of carbohydrates from the intestines. This can help to reduce blood glucose levels after meals.

Acarbose is not typically a concern for patients undergoing CT scans with contrast. However, it is important to note that acarbose can sometimes cause gastrointestinal side effects, such as bloating, gas, and diarrhea. These side effects may be worsened by the contrast media used in CT scans.

Choice C rationale:

Metformin (Glucophage) is a biguanide that works by reducing glucose production in the liver and increasing insulin sensitivity in the muscles. It is a commonly used medication for the treatment of type 2 diabetes.

Metformin is a concern for patients undergoing CT scans with contrast because it can increase the risk of lactic acidosis. Lactic acidosis is a serious condition that can occur when there is a buildup of lactic acid in the blood. It can be caused by metformin, as well as by other factors such as dehydration, kidney problems, and liver problems.

The contrast media used in CT scans can also increase the risk of lactic acidosis. This is because the contrast media can sometimes cause kidney damage, which can impair the body's ability to remove lactic acid from the blood.

For this reason, metformin is typically discontinued for 48 hours before a CT scan with contrast. It is also important to ensure that patients are well-hydrated before and after the scan.

Choice D rationale:

Glipizide (Glucotrol) is a sulfonylurea that works by stimulating the release of insulin from the pancreas. It is a commonly used medication for the treatment of type 2 diabetes.

Glipizide is not typically a concern for patients undergoing CT scans with contrast. However, it is important to monitor blood glucose levels closely in patients with diabetes who are receiving sulfonylurea therapy, as the contrast media used in CT scans can sometimes cause hypoglycemia.