A client who has type 2 diabetes mellitus takes metformin 500 mg PO daily for blood glucose control. The client has been NPO since midnight in preparation for general anesthesia and surgery. At 0700 the client's serum glucose level is 250 mg/dL (13.9 mmol/L). Which action should the nurse implement?
Reference Range:
Fasting Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
Obtain a prescription for regular insulin SUBQ per sliding scale.
Record the blood glucose results and requisition a repeat test in one hour.
Prepare to initiate a continuous IV infusion of Insulin in normal saline.
Administer the client's daily metformin tablet with a sip of water.
The Correct Answer is A
A. Administering insulin per sliding scale is appropriate for managing elevated blood glucose in a patient who is NPO and cannot take oral hypoglycemics like metformin.
B. Repeating the test in one hour delays necessary treatment and does not address the current hyperglycemia.
C. A continuous IV infusion of insulin is more appropriate for severe hyperglycemia or critical care situations, but obtaining a sliding scale prescription is more routine in this context.
D. Administering metformin with a sip of water could be considered if the provider orders it, but typically, oral hypoglycemics are held when a patient is NPO.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Palpating muscle tone is important but should be done in conjunction with resistance testing to assess strength.
B. Asking the client to close his eyes is not necessary for assessing muscle strength.
C. Applying resistance while the client extends and flexes his arms helps evaluate the muscle strength and function accurately.
D. Providing an object to hold is not relevant for assessing muscle strength in this context.
Correct Answer is A
Explanation
A. Acetaminophen, especially in high doses or with prolonged use, is known to cause hepatotoxicity, which can lead to jaundice. Notifying the healthcare provider is crucial to prevent further liver damage.
B. Captopril, an ACE inhibitor used for hypertension, is not commonly associated with jaundice or liver dysfunction.
C. Omeprazole, a proton pump inhibitor used for GERD, is less likely to cause liver damage compared to acetaminophen.
D. Prednisone, a corticosteroid, can have many side effects, but hepatotoxicity is not among the most common, making acetaminophen the most concerning drug in this context.
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