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

Answer and Explanation

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.

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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.

A. The consumption of dairy-based products should be eliminated from the diet. B. The consumption of protein products should come from lean meats, nuts, and dried beans. C. The consumption of bread products should be gluten-free. D. The consumption of fruit and/or vegetables should total between 4 to 6 servings

Correct Answer is B

Explanation

Choice A

The consumption of dairy-based products should be eliminated from the diet. The statement is false Dairy products, especially low-fat or fat-free options, are included in the DASH diet as sources of calcium and other important nutrients. The DASH diet encourages moderation rather than elimination of dairy.

Choice B

The consumption of protein products should come from lean meats, nuts, and dried beans. The statement is correct. The DASH diet encourages including protein sources that are low in saturated fat and high in nutrients. Lean meats, nuts, and dried beans are examples of protein sources that fit this criterion.

Choice C

The consumption of bread products should be gluten-free. The statement is false The DASH diet does not specifically focus on gluten-free options. It emphasizes whole grains as a source of fibre, which is beneficial for heart health.

Choice D

The consumption of fruit and/or vegetables should total between 4 to 6 servings. The statement is false The DASH diet actually encourages a higher intake of fruits and vegetables, aiming for 8 to 10 servings per day. These foods are rich in potassium, magnesium, and fibre, which contribute to the diet's blood pressure-lowering effects.

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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.

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

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