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. Evaluate muscle strength every 4 hours. B. Advise the client to move slowly and cautiously when rising and walking. C. Ensure the client knows to stop baclofen before using other antispasmodics. D. Monitor intake and output every 8 hours.

Correct Answer is B

Explanation

A. Evaluate muscle strength every 4 hours: While assessing muscle strength is important in clients with multiple sclerosis, it does not need to be done this frequently unless the client is unstable. Baclofen may cause weakness, but routine assessments every 4 hours are excessive for stable patients.

B. Advise the client to move slowly and cautiously when rising and walking: Baclofen can cause dizziness, sedation, decreased muscle tone and orthostatic hypotension, particularly in the early stages of treatment. Educating the client to change positions carefully helps reduce the risk of falls and injury.

C. Ensure the client knows to stop baclofen before using other antispasmodics: Baclofen should not be stopped abruptly due to the risk of withdrawal symptoms like hallucinations or seizures. Combining different antispasmodic medications can increase the risk of adverse effects such as excessive sedation or muscle weakness. Medication changes therefore should only be made under the supervision of the healthcare provider.

D. Monitor intake and output every 8 hours: Baclofen does not typically affect renal function or fluid balance significantly. Monitoring intake and output is not a standard intervention specific to baclofen administration unless there is another underlying condition.

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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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Explanation

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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.