Patient Data
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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Exhibits fewer emotional outbursts: Zolpidem is a sedative-hypnotic medication primarily used to treat insomnia. A reduction in emotional outbursts is not a direct expected outcome of this medication. While improved sleep might indirectly influence mood, it is not the primary therapeutic goal.
B. Decreased episodes of incontinence: Zolpidem's primary action is on the central nervous system to promote sleep. A decrease in episodes of incontinence is not a direct pharmacological effect of zolpidem.
C. Improved ability to concentrate: Zolpidem is a sedative and can potentially cause daytime drowsiness or cognitive impairment rather than improving concentration. Its intended effect is to induce sleep, which could indirectly benefit concentration if the client's difficulty concentrating was due to sleep deprivation, but it's not a direct outcome of the medication itself.
D. Sleeps soundly through the night: The intended therapeutic effect of zolpidem is to help the client initiate and maintain sleep. Documentation stating that the client sleeps soundly through the night indicates that the medication has achieved its desired outcome.
Correct Answer is A
Explanation
A. Serum liver enzymes: Statins are metabolized in the liver and can cause hepatotoxicity. Baseline liver enzyme levels, such as ALT and AST, should be reviewed before starting statin therapy to ensure the liver is functioning properly and to monitor for potential adverse effects.
B. Serum electrolytes: Electrolytes are important for overall health, but they are not specifically impacted by statin therapy. Reviewing electrolyte levels is not a priority before initiating statins unless other conditions warrant it.
C. Complete blood count: A complete blood count (CBC) provides valuable information about infection or anemia, but it is not directly related to the safety or monitoring of statin medications.
D. Capillary blood glucose: Statins have been associated with a slight risk of elevated blood glucose over long-term use, but an initial capillary blood glucose reading is not required prior to starting therapy. Liver function assessment is the priority.
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