NR 566 Week 1 - 3 Midterm Exam

NR 566 Week 1 - 3 Midterm Exam NR 566 Week 1 - 3 Midterm Exam Week 1 Professor question: Why are statins recommended in the evening instead of morning? (pg 561) After starting John on insulin, he calls the office saying he feels bad. He said when he checked his blood sugar before calling it was 52 mg/dl. What instructions should he be given? Answer from classmate: Statins are recommended to be taken in the evening. Cholesterol synthesis is highest through the night and first thing in the morning. The biosyntheses of cholesterol follows a normal circadian rhythm. Administration at night allows for the medication to be at peak levels in the body during the time of high cholesterol synthesis (Korani et al., 2019). A blood glucose level 70mg/dL is considered to be hypoglycemia. John called the office with a sugar of 52mg/dL. He would be given instructions that follow "the rule of 15". This means that when symptoms occur, he should consume 15 g of a fast-acting carbohydrate. After 15 minutes, he should recheck his blood glucose. John should also be educated on the best options of carbohydrates to consume. Examples would be 4 oz of juice, four-five hard candies, honey, or half a can of regular soft drink. Another education point is that John needs to have a meal within a few hours after the low blood glucose. He may also need to see his doctor for adjustments to be made on insulin dosage as well as meal patterns to help prevent another low blood glucose episode from occurring (Woo & Robinson, 2016). Professor question: What diabetic medications would be contraindicated in patients with heart failure? Which diabetic drug(s) may have beneficial effects in heart failure? (text has info on this but ADA 2020 guidelines has even more up to date info on this topic, so here is the page. See Recommendation 9.9 and 9.10) answer from classmate: Suppose John was showing signs of heart failure. What diabetic medications would be contraindicated in patients with heart failure? Metformin is contraindicated in patients with renal insufficiency and unstable he