The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.
St. John's Wort
Corticosteroids
Ibuprofen
Oral contraceptives
Epinephrine
Correct Answer : A,B,D,E
Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.
Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice D: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A
Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.
Choice B
Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.
Choice C
Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.
By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.
Choice D
Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.
Correct Answer is A
Explanation
Choice A
Potatoes, bananas, and oranges should be encouraged. Hypokalaemia refers to a lower than normal level of potassium in the blood. Potassium is an essential mineral that plays a crucial role in maintaining proper muscle function, nerve signalling, and fluid balance in the body. To address hypokalaemia, it's important to consume foods that are rich in potassium.
Choice B
Cranberry juice, butter, and hard candy. None of these foods are particularly high in potassium should not be encouraged. Cranberry juice is more commonly associated with urinary tract health, and butter and hard candy do not contribute significant amounts of potassium.
Choice C
Milk products, canned salmon, and fresh oysters should not be encouraged. While milk products contain some potassium, they are not as potent a source as other options. Canned salmon and fresh oysters do provide some potassium, but they are not as well-known for their potassium content as other foods like bananas and potatoes.
Choice D
Hard cheese, whole grain cereals, and dried vegetables should not be encouraged. These foods are not known for being particularly high in potassium. Hard cheese and whole grain cereals have limited potassium content, and dried vegetables, while containing some potassium, are not among the best sources.

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