Patient Data

Exhibits

Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Ibuprofen

Oral contraceptive

Corticosteroids

Epinephrine

St. John's Wort

Fluconazole

Answer and Explanation

Correct Answer : B,C,D,F

A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.

B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.

C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.

D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.

E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.

F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.

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Correct Answer is A

Explanation

A. Hold both medications until contacting the healthcare provider (HCP): A total calcium level of 14 mg/dL is critically high and indicates hypercalcemia. Continuing calcitriol or calcium carbonate could worsen the hypercalcemia, so both medications should be held and the HCP contacted immediately for further orders.

B. Hold the calcitriol, but administer the calcium carbonate as scheduled: Calcium carbonate increases serum calcium levels, and administering it would exacerbate the already dangerously high calcium level. It should not be given until the situation is reassessed.

C. Hold the calcium carbonate, but administer the calcitriol as scheduled: Calcitriol promotes intestinal absorption of calcium, which could further elevate serum calcium levels. Giving calcitriol would be unsafe until the client’s calcium status is re-evaluated.

D. Administer both prescribed medications as scheduled: Administering both medications would significantly increase the risk of severe hypercalcemia complications, such as cardiac arrhythmias or neurologic changes, and must be avoided until new instructions are received.

A. Large, liquid stool B. Abdomen soft and flat C. Blood pressure 120/68 mm Hg D. Drowsiness E. Heart rate 62 beats/minute F. Pain rating of 2 on a 0 to 10 G. Cramping

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"C"},"G":{"answers":"B"}}

Explanation

Large, liquid stool: Lactulose is prescribed to treat constipation by drawing water into the bowel and promoting a bowel movement. A large, liquid stool indicates that the medication has effectively relieved the client's postoperative constipation.

Abdomen soft and flat: Before receiving lactulose, the client had a distended abdomen. A soft, flat abdomen afterward shows that bowel motility improved and gas or stool buildup has decreased, reflecting therapeutic action.

Blood pressure 120/68 mm Hg: Lactulose does not significantly affect blood pressure. A normal blood pressure reading is a positive finding but is unrelated to the expected outcomes or side effects of lactulose therapy.

Drowsiness: Drowsiness is not an intended or expected effect of lactulose. It may result from opioid use (morphine) rather than the lactulose itself, but since it impacts the client's alertness, it is considered a nontherapeutic side effect here.

Heart rate 62 beats/minute: Lactulose has no direct pharmacologic impact on heart rate. A heart rate of 62 beats per minute is within acceptable limits for many adults and is unrelated to the administration of lactulose.

Pain rating of 2 on a 0 to 10 scale: Pain control relates to the administration of morphine and other analgesics, not to lactulose. Therefore, a lower pain score reflects effective analgesia but is not linked to lactulose therapy.

Cramping: Cramping can occur with lactulose because it increases bowel motility and draws fluid into the intestines. Although mild cramping is expected, it is still classified as a nontherapeutic side effect because it can cause client discomfort.

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Patient Data Exhibits Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?Reference Range:Calcium [8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L]

Correct Answer is A

Explanation

Patient Data Exhibits Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"C"},"G":{"answers":"B"}}

Explanation

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Patient Data

Exhibits

Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.