Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

Choice A rationale:

Glipizide does not directly enhance glucose transport into the muscles. This action is primarily mediated by insulin, which increases the expression of glucose transporter proteins (GLUT4) on muscle cell membranes, facilitating glucose uptake.

While glipizide can indirectly improve glucose transport into muscles by increasing insulin levels, it's not the primary mechanism of action.

Choice B rationale:

Glipizide does not directly facilitate glucose utilization by body cells. This process also largely depends on insulin, which activates intracellular pathways that promote glucose metabolism and energy production.

Although glipizide can indirectly enhance glucose utilization by increasing insulin availability, it's not the main mechanism responsible for its glucose-lowering effects.

Choice C rationale:

Glipizide does not boost glucose levels. In fact, it has the opposite effect, lowering blood glucose levels by stimulating insulin secretion.

Elevating glucose levels would be counterproductive in diabetes management, as the goal is to maintain blood glucose within a healthy range.

Choice D rationale (correct answer):

Glipizide belongs to a class of medications called sulfonylureas, which act primarily by stimulating insulin secretion from pancreatic beta cells.

Insulin is a hormone that plays a crucial role in regulating blood glucose levels. It promotes glucose uptake by various tissues, including muscles, liver, and adipose tissue, and it inhibits glucose production by the liver.

By triggering insulin release, glipizide effectively lowers blood glucose levels. This helps to prevent the long-term complications of diabetes, such as damage to blood vessels, nerves, and organs.

Choice A rationale:

Uncontrolled diabetes mellitus: Corticosteroids can have a hyperglycemic effect, meaning they can raise blood sugar levels. This makes them generally unsuitable for use in patients with uncontrolled diabetes mellitus. In fact, corticosteroids might even worsen glycemic control in these patients. While corticosteroids might be used in some cases of diabetes mellitus, such as to treat diabetic retinopathy or nephropathy, they would be used cautiously and with close monitoring of blood sugar levels.

Choice B rationale:

A recent diagnosis of lung cancer: Corticosteroids are not a primary treatment for lung cancer. They might be used in some cases to help manage symptoms or side effects of other treatments, such as chemotherapy or radiation therapy. However, they would not typically be used as a first-line treatment for lung cancer itself.

Choice C rationale:

Acute exacerbation of COPD: Corticosteroids are a mainstay of treatment for acute exacerbations of COPD. They work by reducing inflammation in the airways, which helps to improve airflow and relieve symptoms such as wheezing, shortness of breath, and chest tightness. Corticosteroids can be given orally, intravenously, or by inhalation. The dose and duration of treatment will depend on the severity of the exacerbation.

Choice D rationale:

Chronic asthma: Corticosteroids are often used as a long-term control medication for chronic asthma. However, they are typically used at lower doses than those used for acute exacerbations of COPD. Inhaled corticosteroids are the preferred form of treatment for chronic asthma, as they deliver the medication directly to the airways and have fewer systemic side effects.