Chapter 35: Drugs Used to Treat Diabetes Mellitus Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition

1. A patient received the evening dose of Lispro subcutaneously at 16:30. What time will symptoms of hypoglycemia likely occur? a. 19:00 b. 18:30 c. 01:30 d. 06:00 ANS: B The most rapid-acting insulin, Lispro, peaks within 1 to 2 hours after administration. The peak time of insulin is when patients would most likely exhibit symptoms of hypoglycemia, particularly if they have inadequate dietary intake. The time of 19:00 would be past the peak of action and after signs of hypoglycemia would have appeared. The times of 01:30 and 06:00 are long after the peak of action and the time when signs of hypoglycemia would have appeared. DIF: Cognitive Level: Application REF: Page 551 | Page 552 OBJ: 2 | 3 | 4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Glucose Regulation; Safety 2. It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for the nurse to take? a. Have the patient eat a snack and drink milk. b. Administer glucagon subcutaneously. c. Call the bronchoscopy room to follow up with the delay. d. Obtain an A1c test. ANS: B Irritability, nervousness, headache, tremors, dizziness, apprehension, sweating, cold and clammy skin, and hunger are symptoms of hypoglycemia. The patient has not eaten since the prior day. A blood glucose of 50 mg/dL is true hypoglycemia and needs to be dealt with immediately. Glucagon is preferred over PO intake, given that an endoscopy is scheduled. Having the patient eat a snack and drink milk, calling the bronchoscopy room, and obtaining an A1c test are not appropriate responses. DIF: Cognitive Level: Analysis REF: Page 546 OBJ: 2 | 3 | 4 TOP: Nursing Process Step: Diagnosis MSC: N