Examkin

Soru

Zorluk: OrtaPharmacological Therapies

A practical nurse is caring for a client with type 2 diabetes mellitus who is scheduled for an abdominal computed tomography (CT) scan and has been prescribed NPO (nothing by mouth) status since midnight. The morning medication administration record includes prescriptions for oral glipizide and subcutaneous insulin lispro. The client's point-of-care blood glucose level is 6464 mg/dL. Which of the following actions should the practical nurse take?

  1. A
    Administer the subcutaneous insulin lispro to maintain basal glycemic control but withhold the oral glipizide.
  2. B
    Administer the oral glipizide with a minimal sip of water and hold the insulin lispro until after the scan.
  3. Withhold both the glipizide and the insulin lispro, and immediately notify the registered nurse or healthcare provider.Cevap
  4. D
    Provide four ounces of apple juice to correct the blood glucose, then administer both medications.

Cevap

The practical nurse should withhold both the oral glipizide and the subcutaneous insulin lispro, and immediately notify the registered nurse or healthcare provider.
The client is experiencing hypoglycemia (blood glucose less than 7070 mg/dL) and is NPO for a diagnostic procedure. Administering either glipizide (a sulfonylurea) or insulin lispro (a rapid-acting insulin) without food will exacerbate the hypoglycemia, potentially leading to seizures or coma. Furthermore, the practical nurse must escalate this critical laboratory finding to the registered nurse or provider, as the client's hypoglycemia requires treatment that may conflict with the NPO order (e.g., administering intravenous dextrose instead of oral juice).

Adım Adım Çözüm

1
Identify the client's current physiological status.
The client is NPO, has a low blood glucose of 6464 mg/dL (hypoglycemia), and is awaiting a diagnostic procedure.
Establishing the baseline condition is necessary before safely administering any pharmacological therapy.
2
Analyze the prescribed medications' onset and mechanisms of action.
Glipizide stimulates insulin release, and insulin lispro is a rapid-acting insulin. Both require adequate food intake to prevent severe hypoglycemia.
Understanding pharmacokinetics ensures safe medication administration and prevents adverse drug events.
3
Determine the appropriate nursing action based on the practical nurse scope of practice.
The medications must be withheld to prevent life-threatening hypoglycemia, and the registered nurse or provider must be notified to determine the next steps for treating the hypoglycemia while managing the NPO status.
Practical nurses must escalate critical laboratory findings and recognize contraindications to delegated medications.

Anahtar Kavram

Pre-administration withholding criteria and medication safety for hypoglycemic, NPO clients
Bu soruyu puanla

Konular

Pharmacological Therapies

Bu konudan daha fazla soru