A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Perform a neurological exam.

Obtain a fingerstick blood glucose.

Administer glucagon intramuscularly.

Measure the client's vital signs.

Answer and Explanation

The Correct Answer is B

Choice A reason: Performing a neurological exam is not the priority action in this situation. Confusion and blurred vision are signs of hypoglycemia, which is a low blood sugar level. Glipizide is a medication that lowers blood sugar by stimulating the pancreas to produce more insulin. The nurse should first confirm the blood sugar level before performing any other assessments or interventions.

Choice B reason: Obtaining a fingerstick blood glucose is the best action in this situation. This is a quick and easy way to measure the blood sugar level and determine if the client is experiencing hypoglycemia. The nurse should use a glucometer and a lancet to prick the client's finger and obtain a drop of blood. The nurse should compare the result with the normal range and follow the hypoglycemia protocol.

Choice C reason: Administering glucagon intramuscularly is not the first action in this situation. Glucagon is a hormone that raises blood sugar by stimulating the breakdown of glycogen in the liver. It is used as an emergency treatment for severe hypoglycemia, when the client is unconscious or unable to swallow. The nurse should only administer glucagon after confirming the blood sugar level and trying oral glucose first.

Choice D reason: Measuring the client's vital signs is not the priority action in this situation. Vital signs include blood pressure, pulse, respiration, and temperature. They can provide information about the client's overall health and stability, but they are not specific to hypoglycemia. The nurse should focus on the blood sugar level, which is the most relevant indicator of hypoglycemia.

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Correct Answer is B

Explanation

The correct answer is b. Liver function laboratory results.

Choice A reason:

Weight change in the last month can be an important factor to consider for a patient's overall health and may be relevant in the context of depression, as significant weight changes can be a symptom of this condition. However, it is not the most critical piece of information before prescribing duloxetine. Duloxetine is not primarily metabolized by the kidneys, and while weight can affect dosing and efficacy, it is not the most crucial factor to consider before starting treatment.

Choice B reason:

Liver function laboratory results are crucial to obtain before prescribing duloxetine because duloxetine is extensively metabolized by the liver. The prescribing information for duloxetine warns of the potential for hepatotoxicity, and hepatic failure has been reported in some cases. Therefore, it is essential to ensure that the patient's liver function is normal before initiating therapy with duloxetine, as impaired liver function could lead to increased levels of the medication in the body and a higher risk of side effects.

Choice C reason:

Recent use of other antidepressants is important to consider avoiding drug interactions, particularly with monoamine oxidase inhibitors (MAOIs), which can lead to serious, life-threatening side effects if taken together with duloxetine. While this information is important, it is not as critical as liver function, because the primary concern with other antidepressants is the timing of medication changes rather than an absolute contraindication.

Choice D reason:

A family history of mental illness can provide valuable information for understanding a patient's background and potential genetic predispositions to certain conditions. However, this information does not directly impact the safety and initial prescribing of duloxetine. It may be more relevant for long-term treatment considerations and prognosis rather than immediate prescription safety.

A. Take medication on an empty stomach. B. Consume foods that are high in iodine. C. Administer levothyroxine at bedtime. D. Avoid the use of iron supplements.

Correct Answer is A

Explanation

Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.

Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.

Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.

Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.

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A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

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