A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus to be used at home. When should the nurse instruct the client and family that glucagon needs to be administered?

At the onset of signs of diabetic ketoacidosis.

Before meals to prevent hyperglycemia.

When unable to eat during sick days.

When signs of severe hypoglycemia occur.

Answer and Explanation

The Correct Answer is D

Choice A reason: Diabetic ketoacidosis is a complication of diabetes that occurs when the body produces high levels of ketones due to lack of insulin. Glucagon is not indicated for this condition, as it would increase the blood glucose level even more. The nurse should instruct the client and family to monitor the blood glucose and ketone levels, administer insulin as prescribed, and seek medical attention if the condition worsens.

Choice B reason: Glucagon is not used to prevent hyperglycemia, which is a high blood glucose level. Glucagon is a hormone that raises the blood glucose level by stimulating the breakdown of glycogen in the liver. The nurse should instruct the client and family to prevent hyperglycemia by following a balanced diet, taking insulin as prescribed, and exercising regularly.

Choice C reason: Glucagon is not used when the client is unable to eat during sick days, unless the client has signs of hypoglycemia, which is a low blood glucose level. Glucagon is used as a last resort when the client is unconscious or unable to swallow. The nurse should instruct the client and family to follow the sick day rules, which include monitoring the blood glucose and urine ketone levels, taking insulin as prescribed, drinking fluids, and eating small amounts of carbohydrates.

Choice D reason: Glucagon is used when the client has signs of severe hypoglycemia, such as confusion, seizures, or loss of consciousness. Glucagon is injected subcutaneously or intramuscularly by a family member or a caregiver to raise the blood glucose level quickly. The nurse should instruct the client and family to recognize the signs of hypoglycemia, treat mild to moderate hypoglycemia with oral glucose, and call 911 after administering glucagon.

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Correct Answer is D

Explanation

Choice A reason: Decreasing pain and burning during urination is not the purpose of probenecid, which is a drug that lowers the level of uric acid in the blood. Probenecid is used to treat gout, a condition that causes painful inflammation of the joints due to the accumulation of uric acid crystals. Probenecid does not have any effect on the urinary tract or its symptoms.

Choice B reason: Increasing the strength of the urine stream is not the purpose of probenecid, which is a drug that increases the amount of uric acid in the urine. Probenecid works by blocking the reabsorption of uric acid by the kidneys, thus increasing its excretion. Probenecid does not have any effect on the bladder or its function.

Choice C reason: Preventing the formation of kidney stones is not the purpose of probenecid, which is a drug that can actually increase the risk of kidney stones. Probenecid increases the concentration of uric acid in the urine, which can lead to the formation of uric acid stones. The nurse should instruct the client to drink plenty of fluids and avoid foods high in purines, such as organ meats, seafood, and alcohol, to prevent kidney stones.

Choice D reason: Promoting excretion of uric acid in the urine is the purpose of probenecid, which is a drug that reduces the level of uric acid in the blood. Probenecid helps prevent gout attacks by preventing the buildup of uric acid crystals in the joints. The nurse should monitor the client's serum uric acid level, renal function, and urine output, and advise the client to take the medication with food to avoid stomach upset.

A. Measure the client's urinary output. B. Explain the color change is normal. C. Obtain a specimen for a urine culture. D. Encourage an increase in oral intake.

Correct Answer is B

Explanation

Choice A reason: Measuring the client's urinary output is not the most appropriate action for the nurse to take. Although urinary output is an important indicator of renal function, it is not related to the color change of the urine. The nurse should monitor the client's fluid balance as part of the routine care, but it is not a priority.

Choice B reason: Explaining the color change is normal is the most appropriate action for the nurse to take. Carbidopa/levodopa can cause the urine to become dark brown or black, which is a harmless side effect. The nurse should reassure the client that this is not a sign of a serious problem and does not affect the effectiveness of the medication.

Choice C reason: Obtaining a specimen for a urine culture is not the most appropriate action for the nurse to take. A urine culture is used to diagnose a urinary tract infection (UTI), which is characterized by symptoms such as dysuria, frequency, urgency, and hematuria. The color change of the urine due to carbidopa/levodopa is not indicative of a UTI. The nurse should obtain a urine culture only if the client has signs or symptoms of a UTI.

Choice D reason: Encouraging an increase in oral intake is not the most appropriate action for the nurse to take. Although adequate hydration is important for the client's health, it is not related to the color change of the urine. The nurse should encourage the client to drink enough fluids to prevent dehydration, but it is not a priority.

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A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus to be used at home. When should the nurse instruct the client and family that glucagon needs to be administered?

Nursing Test Bank

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