The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

Test a sample of urine for the presence of occult blood

Check the client's weight

Instruct the client to increase his water intake

Review results of liver function studies

Answer and Explanation

The Correct Answer is D

A.   While testing for occult blood can help rule out hematuria (blood in the urine), it’s not the immediate priority. Dark urine could be related to several factors, including dehydration or changes in liver function, making this not the best first step.
B.   While monitoring weight is important, it doesn't directly address the issue of dark urine. Weight changes might indicate fluid retention or loss but are not as immediately relevant to the urine color change.
C.   Increasing water intake can help dilute the urine and may help with hydration. However, before suggesting this, it's important to understand the underlying cause of the urine change.
D.   Glipizide and other sulfonylureas can affect liver function, and dark urine can indicate potential liver issues, such as bilirubinuria (bilirubin in the urine). Reviewing liver function studies would provide critical information to assess if the change in urine color is related to liver dysfunction or other serious issues.

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Correct Answer is A

Explanation

A. The client's fasting blood glucose levels (70-80 mg/dl) are within the normal range, and a post- prandial blood glucose level below 200 mg/dl is also considered well-controlled, particularly for someone on an intensified insulin regimen. The hemoglobin A1c level of 4.5% indicates excellent long- term glucose control, typically representing average blood glucose levels of around 90 mg/dl.
B. Hyperglycemia is characterized by elevated blood glucose levels. Given the client's consistently normal fasting and post-prandial levels, they are not at an increased risk for hyperglycemia. Instead, they are maintaining their glucose levels well.
C. Insulin resistance typically manifests as elevated blood glucose levels despite adequate insulin levels or increased insulin requirements. In this case, the client's blood glucose levels are well-controlled, indicating that they are likely responding well to insulin therapy and are not showing signs of insulin resistance.
D. While the client’s blood glucose levels are well-controlled, the risk for hypoglycemia depends on various factors, including insulin dosage, timing, and food intake. However, consistently normal levels do not directly indicate a risk for hypoglycemia unless insulin doses are excessively high or meals are skipped. Therefore, this choice is not justified given the data provided.

A. importance of exercise. B. administration of insulin. C. the diabetic diet. D. urine testing for ketones.

Correct Answer is B

Explanation

A. While exercise is an important aspect of diabetes management, particularly for blood glucose control and overall health, it is not the immediate priority for a newly diagnosed client. Understanding how to manage blood glucose levels is more critical initially.
B. For a client who is newly diagnosed with insulin-dependent diabetes, learning how to administer insulin is essential. This includes understanding how to prepare, inject, and store insulin, as well as recognizing the signs of hypoglycemia and hyperglycemia. Proper insulin administration is crucial for managing blood glucose levels and preventing complications.
C. Understanding dietary management is important in diabetes care, as it plays a significant role in blood sugar control. However, without knowing how to administer insulin, a client may struggle to manage their blood glucose levels effectively, making insulin administration a higher priority initially.
D. While monitoring urine for ketones is important, particularly in cases of potential diabetic ketoacidosis (DKA), this is not the first priority for a newly diagnosed client. The focus should be on fundamental skills and knowledge for managing diabetes, such as insulin administration.

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The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client, on an intensified insulin regimen, consistently has a fasting blood glucose between 70 and 80 mg/dl, a post prandial blood glucose level below 200 mg/dl, and a hemoglobin A1c level of 4.5%. What is the nurse's interpretation of these findings? The client is:

Correct Answer is A

Explanation

The client newly diagnosed with insulin dependent diabetes is to be discharged in the morning and has received no instruction on diabetes. The nurse's teaching priority is to instruct the client in:

Correct Answer is B

Explanation

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