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:

Incorrect. Insulin pumps should be removed before bathing or swimming to prevent damage to the device. Water can enter the pump through the infusion set or through the battery compartment, causing it to malfunction. This can lead to inaccurate insulin delivery, which can result in hyperglycemia or hypoglycemia.

Additionally, the adhesive that holds the infusion set in place may not stick well to wet skin, which can increase the risk of the infusion set falling out.

It is important to note that some insulin pumps are now waterproof and can be worn while bathing or swimming. However, it is still important to check the manufacturer's instructions before doing so.

Choice B rationale:

Correct. Even though insulin pumps deliver insulin continuously, people who use them still need to monitor their blood glucose levels regularly. This is because many factors can affect blood glucose levels, such as food intake, exercise, stress, and illness.

Monitoring blood glucose levels allows people to adjust their insulin doses as needed to keep their blood glucose levels within a target range.

Recommended frequency of blood glucose monitoring:

Before meals and snacks Two hours after meals At bedtime

Before and after exercise During times of illness or stress

Whenever they feel symptoms of hypoglycemia or hyperglycemia

Choice C rationale:

Incorrect. People who use insulin pumps still need to count carbohydrates. This is because the amount of insulin that is needed to cover a meal depends on the amount of carbohydrates in the meal.

The insulin pump can be programmed to deliver different amounts of insulin for different meals, snacks, and corrections based on carbohydrate intake. This allows for more precise insulin dosing and better blood glucose control.

Choice D rationale:

Incorrect. Insulin pumps are not designed to help people lose weight. They are designed to help people manage their blood glucose levels.

While some people may lose weight when they start using an insulin pump, this is usually due to improved blood glucose control rather than the pump itself.

Choice A rationale:

Fever is not a common side effect of metformin. While it's possible for a minority of patients to experience a mild fever as their bodies adjust to the medication, it's not considered a typical or expected adverse effect.

Fevers typically occur due to infections or inflammation, and metformin does not directly cause either of these processes.

If a patient taking metformin develops a fever, it's crucial to rule out other potential causes, such as infections or other medications, before attributing it to metformin.

Choice B rationale:

Insomnia is also not a common side effect of metformin. In fact, some studies have suggested that metformin may even have a positive effect on sleep quality in some individuals.

While sleep disturbances can occur with any medication, they are not specifically associated with metformin.

If a patient experiences insomnia while taking metformin, it's essential to consider other potential factors, such as stress, anxiety, or other medications, that could be contributing to sleep problems.

Choice C rationale:

Bitter or metallic taste is a very common side effect of metformin, experienced by approximately 30-40% of patients. This taste disturbance is thought to be caused by metformin's interaction with taste receptors on the tongue.

The taste is often described as metallic, bitter, or similar to the taste of pennies.

While it can be unpleasant, it's generally not considered a serious side effect and does not usually require discontinuation of the medication.

Some strategies to manage the metallic taste include: Taking metformin with meals or snacks to mask the taste.

Chewing sugar-free gum or sucking on hard candy after taking the medication. Rinsing the mouth with water or mouthwash after taking the medication.

Switching to an extended-release formulation of metformin, which may have a less pronounced metallic taste.

Choice D rationale:

Seizures are a rare but serious side effect of metformin.

They are most likely to occur in patients with underlying kidney problems or those taking certain other medications that can interact with metformin.

If a patient taking metformin experiences a seizure, it's critical to seek immediate medical attention.