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 B

Explanation

Choice A

Protein is not essential. While protein can influence blood sugar levels to some extent, its effect is much smaller compared to carbohydrates. Protein is not typically counted as a primary factor in insulin dosing.

Choice B

Carbohydrates are essential. For a client with type 1 diabetes mellitus who uses both short-acting (mealtime) and long-acting (basal) insulin, counting carbohydrates is essential for meal planning and insulin dosing. Carbohydrates have the most direct and significant impact on blood sugar levels. When carbohydrates are consumed, they are broken down into glucose, which enters the bloodstream and can lead to increased blood sugar levels

Choice C

Dairy is not essential. Dairy products can contain carbohydrates (such as lactose), but the carbohydrate content varies and is not as significant as in foods like grains, fruits, and starchy vegetables.

Choice D

Fats are not essential. Fats have minimal direct impact on blood sugar levels. However, they can affect the overall rate of digestion and absorption of carbohydrates, potentially influencing the timing of insulin administration. But carbohydrate counting remains the primary focus for insulin adjustment.

A. Follow low carbohydrate diet with low glycaemic index foods. B. Eat a high protein diet three times a day. C. Avoid foods high in potassium. D. Restrict sodium rich foods and excessive oral fluids.

Correct Answer is C

Explanation

Choice A

Following low carbohydrate diet with low glycaemic index foods is incorrect. This recommendation is not specifically related to the management of glomerulonephritis. While managing carbohydrate intake might be relevant for individuals with diabetes, it's not the primary focus for someone with kidney inflammation.

Choice B

Eating a high protein diet three times a day is incorrect: While protein is important for overall health and recovery, a high protein diet might not be the best recommendation for someone with compromised kidney function. Excessive protein intake could potentially put additional strain on the kidneys.

Choice C

Avoiding foods high in potassium is correct. Examples of foods high in potassium that the client should be cautious about include bananas, oranges, potatoes, tomatoes, spinach, and other fruits and vegetables. Glomerulonephritis is a condition involving inflammation of the glomeruli in the kidneys, which can affect kidney function and the regulation of electrolytes, including potassium. In glomerulonephritis, the kidneys might have difficulty filtering and excreting excess potassium, leading to a potential build-up of potassium in the blood (hyperkalaemia).

Choice D

Restricting sodium rich foods and excessive oral fluids is incorrect. This recommendation aligns more closely with managing fluid retention and blood pressure, which can be relevant for individuals with kidney issues. However, the primary concern in glomerulonephritis is often potassium balance, making the recommendation to avoid high potassium foods more pertinent.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with type 1 diabetes mellitus who uses both short-acting and long-acting insulin adjusted doses throughout the day. Which nutrient is essential for the client to count for each meal and snacks?

Correct Answer is B

Explanation

A client with glomerulonephritis is preparing for discharge and asks the nurse which kind of diet to follow upon returning home. Which dietary teaching should the nurse include in the discharge instructions?

Correct Answer is C

Explanation

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