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 D

Explanation

A. Headache: Although headache can occur as a mild side effect of azithromycin, it is not typically serious or life-threatening. It does not require immediate reporting unless it is severe or associated with other concerning symptoms.

B. Urinary frequency: Urinary symptoms like frequency are not common adverse effects of azithromycin. If present, they are more likely related to the underlying infection rather than the medication itself.

C. Flatulence and nausea: Gastrointestinal symptoms such as nausea and flatulence are common and expected with azithromycin. They are usually mild and do not require the client to contact the healthcare provider unless they become severe or persistent.

D. Yellow sclera: Yellowing of the sclera is a sign of jaundice, which could indicate liver dysfunction. Azithromycin can rarely cause hepatotoxicity, making this symptom important to report immediately to the healthcare provider for evaluation.

A. Take the medication an hour after antacids. B. Notify the healthcare provider (HCP) of lethargy. C. Monitor for any signs of sexual dysfunction. D. Decrease cigarette use to a pack per day.

Correct Answer is D

Explanation

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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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

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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.