A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
Withhold all medications as ordered.
Contact the prescriber to clarify orders.
Administer half the original dose.
Give the medication with a sip of water.
The Correct Answer is B
Choice A reason: This is incorrect because withholding all medications may cause hyperglycemia or ketoacidosis in the patient, especially if they are taking insulin or sulfonylureas. The nurse should consult with the prescriber to adjust the dose or timing of the medications according to the patient's blood glucose level and the duration of the procedure.
Choice B reason: This is correct because contacting the prescriber to clarify orders is the best action by the nurse, as the prescriber can provide specific instructions on how to manage the patient's oral antidiabetic drugs before and after the oral endoscopy. The nurse should also monitor the patient's blood glucose level closely and report any abnormal findings to the prescriber.
Choice C reason: This is incorrect because administering half the original dose may not be appropriate for the patient, as it may cause hypoglycemia or hyperglycemia depending on the type and dose of the medication and the patient's blood glucose level. The nurse should not make any changes to the medication regimen without the prescriber's approval.
Choice D reason: This is incorrect because giving the medication with a sip of water may violate the NPO status of the patient, which is necessary to prevent aspiration or interference with the oral endoscopy. The nurse should not administer any oral medications or fluids to the patient unless the prescriber allows it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is a. Alcohol.
Choice A: Alcohol
Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.
Choice B: Milk
Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.
Choice C: Grapefruit juice
Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.
Choice D: Coffee
Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.
Correct Answer is C
Explanation
Choice A reason: Vaginal cultures are not necessary for oral contraceptive therapy. They are used to diagnose infections such as bacterial vaginosis, yeast infection, or sexually transmitted diseases.
Choice B reason: Complete blood count is not essential for oral contraceptive therapy. It is used to measure the number and types of blood cells, such as red blood cells, white blood cells, and platelets.
Choice C reason: Serum potassium level is the most important laboratory test for oral contraceptive therapy. This is because some oral contraceptives can increase the risk of hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause serious complications such as cardiac arrhythmias, muscle weakness, and paralysis.
Choice D reason: Pregnancy test is not a laboratory test, but a urine test. It is important to rule out pregnancy before starting oral contraceptive therapy, but it is not the most important test for the nurse to assess.
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