Which of the following is important for the nurse to assess and monitor in a patient prescribed metformin (Glucophage)? (Select All that Apply.)

Presence of renal or hepatic disease

Fluid retention

Need for diagnostic tests involving use of contrast dyes

Weight gain

Presence of heart failure

Answer and Explanation

Correct Answer : A,C,E

A. Presence of renal or hepatic disease: Metformin, commonly prescribed for type 2 diabetes, is primarily excreted by the kidneys. Patients with renal impairment are at increased risk of metformin accumulation, potentially leading to lactic acidosis. Assessing for the presence of renal or hepatic disease helps determine the appropriate dosage of metformin and reduces the risk of adverse effects.
B. Fluid retention: Metformin does not typically cause fluid retention; however, monitoring for signs of fluid retention is important, especially in patients with underlying conditions such as heart failure, as fluid retention can exacerbate their condition.
C. Need for diagnostic tests involving the use of contrast dyes: Metformin can increase the risk of lactic acidosis, particularly in patients undergoing procedures involving contrast dyes. Temporarily discontinuing metformin before such procedures reduces the risk of adverse effects.
D. Weight gain: Metformin is associated with weight neutrality or even modest weight loss. Monitoring weight changes can help assess treatment response and overall health.
E. Presence of heart failure: Metformin is contraindicated in patients with severe heart failure due to the potential risk of lactic acidosis. Assessing for the presence of heart failure helps ensure safe prescribing practices and avoids potential complications associated with metformin use in this population.

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Correct Answer is D

Explanation

A. The patient may choke: This is not the primary concern for extended-release medications like metformin (Glucophage XL). While choking is a risk with any pill, it's not specific to the need for avoiding crushing or chewing extended-release formulations.
B. It would cause blood glucose levels to rise too rapidly: Crushing or chewing the medication would not cause blood glucose levels to rise rapidly. Instead, it could lead to a more rapid release and absorption of the drug, which might lower blood glucose too quickly, potentially leading to hypoglycemia.
C. Irritation of the oral mucosa may occur: While irritation of the oral mucosa could be a concern with some medications, it is not the primary reason for avoiding the crushing or chewing of extended-release formulations like Glucophage XL.
D. The effect of the medication may be changed: Crushing or chewing an extended-release tablet disrupts its formulation. Glucophage XL is designed to release metformin slowly over time. If the tablet is crushed or chewed, it can result in the entire dose being released at once, which can alter the intended pharmacokinetics and pharmacodynamics of the drug. This could lead to a higher risk of side effects and a loss of the extended-release benefit, ultimately changing the medication's effect and possibly leading to issues like hypoglycemia or gastrointestinal side effects.

A. Diarrhea B. Hives or shortness of breath C. Headaches D. Nausea

Correct Answer is B

Explanation

A. Diarrhea: Diarrhea is a common side effect of antibiotics due to their effect on the gut microbiota, but it is not typically indicative of an allergy.
B. Hives or shortness of breath: Hives (urticaria) and shortness of breath are classic symptoms of an allergic reaction. Hives indicate an immediate hypersensitivity reaction, and shortness of breath can indicate a serious allergic reaction such as anaphylaxis. These symptoms warrant caution and further assessment before starting antimicrobial therapy.
C. Headaches: Headaches can be a side effect of various medications but are not a specific sign of a drug allergy.
D. Nausea: Nausea is a common side effect of many medications, including antibiotics, but it does not specifically indicate an allergic reaction.

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Which of the following is important for the nurse to assess and monitor in a patient prescribed metformin (Glucophage)? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Why must the nurse instruct a patient receiving metformin (Glucophage XL) to avoid crushing or chewing the medication?

Correct Answer is D

Explanation

Before starting antimicrobial therapy, the nurse assesses a patient for possible drug allergy. Which of the following complaints should alert the nurse to a drug allergy?

Correct Answer is B

Explanation

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