Which client statement indicates understanding of the use of an external insulin pump?
“I will leave this on when bathing or swimming”
“I will still need to monitor my blood glucose levels.”
“I will not need to count carbohydrates anymore.”
“Having an insulin pump will help me lose weight.”
The Correct Answer is B
Choice A rationale:
Incorrect. Insulin pumps should be removed before bathing or swimming to prevent damage to the device. Water can enter the pump through the infusion set or through the battery compartment, causing it to malfunction. This can lead to inaccurate insulin delivery, which can result in hyperglycemia or hypoglycemia.
Additionally, the adhesive that holds the infusion set in place may not stick well to wet skin, which can increase the risk of the infusion set falling out.
It is important to note that some insulin pumps are now waterproof and can be worn while bathing or swimming. However, it is still important to check the manufacturer's instructions before doing so.
Choice B rationale:
Correct. Even though insulin pumps deliver insulin continuously, people who use them still need to monitor their blood glucose levels regularly. This is because many factors can affect blood glucose levels, such as food intake, exercise, stress, and illness.
Monitoring blood glucose levels allows people to adjust their insulin doses as needed to keep their blood glucose levels within a target range.
Recommended frequency of blood glucose monitoring:
Before meals and snacks Two hours after meals At bedtime
Before and after exercise During times of illness or stress
Whenever they feel symptoms of hypoglycemia or hyperglycemia
Choice C rationale:
Incorrect. People who use insulin pumps still need to count carbohydrates. This is because the amount of insulin that is needed to cover a meal depends on the amount of carbohydrates in the meal.
The insulin pump can be programmed to deliver different amounts of insulin for different meals, snacks, and corrections based on carbohydrate intake. This allows for more precise insulin dosing and better blood glucose control.
Choice D rationale:
Incorrect. Insulin pumps are not designed to help people lose weight. They are designed to help people manage their blood glucose levels.
While some people may lose weight when they start using an insulin pump, this is usually due to improved blood glucose control rather than the pump itself.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Dopamine was once considered a first-line vasopressor for cardiogenic shock. However, recent studies have shown that it is associated with increased mortality compared to norepinephrine.
Dopamine has dose-dependent effects on dopamine receptors, beta receptors, and alpha receptors. At low doses (1-5 mcg/kg/min), it primarily stimulates dopamine receptors, leading to renal vasodilation and increased urine output. At moderate doses (5-10 mcg/kg/min), it stimulates beta receptors, resulting in increased heart rate and contractility. At high doses (>10 mcg/kg/min), it stimulates alpha receptors, causing vasoconstriction.
The main concern with dopamine is its potential to cause arrhythmias, particularly at higher doses. This is due to its effects on beta receptors, which can increase heart rate and myocardial oxygen demand.
Additionally, dopamine can cause tachyphylaxis, meaning that its effects can diminish over time, requiring higher doses to achieve the same effect.
Choice B rationale:
Norepinephrine is a potent alpha-adrenergic agonist that causes vasoconstriction, leading to an increase in blood pressure. It has minimal effects on beta receptors, so it is less likely to cause tachycardia and arrhythmias compared to dopamine.
Norepinephrine also has some inotropic effects, meaning that it can increase the strength of contraction of the heart muscle.
Studies have shown that norepinephrine is associated with improved survival rates in patients with cardiogenic shock compared to dopamine.
It is generally well-tolerated, with the most common side effects being hypertension and peripheral vasoconstriction.
Choice C rationale:
Epinephrine is a potent alpha- and beta-adrenergic agonist that causes vasoconstriction, increased heart rate, and increased contractility.
It is typically used as a second-line agent in cardiogenic shock, after norepinephrine has failed to achieve adequate blood pressure.
Epinephrine can cause significant tachycardia and arrhythmias, so it should be used with caution in patients with underlying heart disease.
Choice D rationale:
Vasopressin is a hormone that causes vasoconstriction by acting on V1 receptors in vascular smooth muscle. It is sometimes used as an adjunct to norepinephrine in patients with refractory cardiogenic shock.
Vasopressin has the potential to cause coronary vasoconstriction, so it should be used with caution in patients with coronary artery disease.
Correct Answer is A
Explanation
Choice A rationale:
Sildenafil (Viagra) is a phosphodiesterase-5 (PDE-5) inhibitor that is primarily used to treat erectile dysfunction. However, it also has vasodilatory effects, meaning it widens blood vessels. This can lead to a significant drop in blood pressure, especially when combined with nitroglycerin, another potent vasodilator.
Nitroglycerin is commonly used to treat chest pain (angina) and heart failure. It works by relaxing the smooth muscles in blood vessels, which allows them to widen and increase blood flow to the heart. This can help to relieve chest pain and improve heart function.
When sildenafil and nitroglycerin are taken together, their combined vasodilatory effects can cause a severe drop in blood pressure, known as hypotension. This can lead to a number of serious complications, including: dizziness, lightheadedness, fainting, heart attack, stroke.
The risk of hypotension is particularly high in patients who are already taking other medications that can lower blood pressure, such as alpha-blockers or nitrates. It is also important to note that the effects of sildenafil can last for up to 24-48 hours, so it is important to avoid taking nitroglycerin within this timeframe.
Due to the significant risk of hypotension, it is generally recommended that sildenafil be avoided within 24-48 hours of nitroglycerin administration.
Rationales for other choices:
Choice B: Aspirin
Aspirin is an antiplatelet medication that is often used to prevent blood clots. It does not have significant vasodilatory effects and does not interact with nitroglycerin in a way that would contraindicate its use.
Choice C: Adenosine
Adenosine is a medication that is used to treat certain types of arrhythmias (irregular heartbeats). It can cause a brief drop in blood pressure, but this effect is usually mild and transient. Adenosine does not interact with nitroglycerin in a way that would contraindicate its use.
Choice D: Oxygen
Oxygen is a gas that is often used to treat patients with respiratory problems. It does not have any direct vasodilatory effects and does not interact with nitroglycerin.
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