A hospitalized patient who is diabetic received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient was away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray.
What is the best action by the nurse to prevent hypoglycemia?
Request that if testing is further delayed, the patient will eat lunch first.
Send a glass of orange juice to the patient in the diagnostic testing area.
Save the lunch tray for the patient's later return.
Plan to discontinue the evening dose of insulin.
The Correct Answer is B
The patient received 38 U of NPH insulin at 7:00 AM, and by 1:00 PM, the insulin has been active for approximately 6 hours. The patient has missed lunch, which may lead to hypoglycemia, especially with the activity of the insulin.
Sending a glass of orange juice will provide the patient with a quick source of glucose to prevent hypoglycemia. If testing is further delayed, the nurse may request that the patient be allowed to eat lunch first or save the lunch tray for later, but immediate intervention is necessary to prevent hypoglycemia. Discontinuing the evening dose of insulin is not an appropriate action and should not be considered without consulting the healthcare provider.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Cushing syndrome is caused by excessive cortisol production by the adrenal glands, which can result in weight gain and redistribution of fat to the abdomen, giving it a characteristic rounded appearance.
The other options mentioned in the question are not typically associated with Cushing syndrome. Chronically low blood pressure is not typically seen in Cushing syndrome, as cortisol is a hormone that can raise blood pressure. A bronzed appearance of the skin is more commonly seen in conditions like Addison's disease, where there is a deficiency of cortisol. Decreased axillary and pubic hair is not a common finding in Cushing syndrome, although excessive hair growth (hirsutism) may occur due to the excess of androgens produced by the adrenal glands.
Correct Answer is D
Explanation
Therefore, the correct option is d. Glyburide is a sulfonylurea medication used to treat type 2 diabetes. It works by stimulating the beta cells in the pancreas to produce and release more insulin, which helps to lower blood glucose levels.
Option A is incorrect because glyburide does not affect glucagon secretion from the pancreas. Glucagon is a hormone that raises blood glucose levels by promoting the breakdown of glycogen in the liver.
Option b is incorrect because glyburide should not be taken if the morning blood glucose level is less than 70 mg/dL, as this may increase the risk of hypoglycemia.
Option c is incorrect because glyburide does not interact with IV contrast media. However, some types of IV contrast media can cause kidney damage in patients with diabetes, and the use of glyburide should be temporarily discontinued if a patient is undergoing a procedure that involves the use of contrast media.
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