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:

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.