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 B
Explanation
Choice A reason: Dextromethorphan is a cough suppressant that does not affect blood glucose levels. It is safe to use for clients with diabetes.
Choice B reason: Prednisone is a corticosteroid that can cause glucose intolerance by increasing glucose production and decreasing insulin sensitivity. It can worsen hyperglycemia and increase the risk of diabetic complications.
Choice C reason: Atorvastatin is a statin that lowers cholesterol levels and reduces the risk of cardiovascular disease. It does not cause glucose intolerance and may have a beneficial effect on glycemic control.
Choice D reason: Cimetidine is a histamine-2 receptor antagonist that reduces stomach acid production and treats ulcers and gastroesophageal reflux disease. It does not cause glucose intolerance and has no significant interaction with diabetes medications.
Correct Answer is C
Explanation
The correct answer is c. 2,525 mL.
Choice A reason:
1,350 mL is calculated by considering only the lactated Ringer’s IV intake. The calculation is as follows:
- Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL. This option does not include the intake from cefazolin, packed RBCs, sodium chloride boluses, or famotidine.
Choice B reason:
1,600 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.
Choice C reason:
2,525 mL is the correct total intake. The detailed calculation is:
- Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL.
- Cefazolin in 100 mL of 0.9% sodium chloride: 100 mL.
- Two units of packed RBCs: 275 mL + 250 mL = 525 mL.
- Two IV bolus infusions of 250 mL of 6.0% sodium chloride: 250 mL + 250 mL = 500 mL.
- Famotidine in 50 mL of 0.9% sodium chloride: 50 mL.
Adding these together: 1,350 mL + 100 mL + 525 mL + 500 mL + 50 mL = 2,525 mL.
Choice D reason:
2,100 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.
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