A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resis-tance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia.
D
Beta blockers can delay awareness of and response to hypoglycemia by masking signs associated with stimulation of the sympathetic nervous system (eg, tachycardia, palpitations) that hypogly-cemia normally causes. Furthermore, beta blockade impairs glycogenolysis, which is one means by which the body can counteract a fall in blood glucose; beta blockers, therefore, can worsen insulin-induced hypoglycemia. Propranolol does not cause insulin resistance. The incidence of DKA is not increased by concurrent use of propranolol and insulin. Insulin requirements are not increased because of receptor blocking by propranolol.
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A pregnant woman is complaining of frequent heartburn. What statement by the patient indicates to the nurse that teaching has been effective?
A. "Drinking less alcohol should prevent this." B. "Eating larger, less frequent meals will help." C. "I should take antacids before each meal." D. "I will not lie down for 1 hour after eating."
The nurse is caring for a patient with chronic obstructive pulmonary disease. The patient has been receiving oxygen therapy for an extended time. What symptoms would the patient exhibit if he was experiencing oxygen toxicity?
A) Bradycardia and frontal headache B) Dyspnea and substernal pain C) Anger and restlessness D) Poor personal hygiene
When asked why the patient is receiving the drug methylprednisolone, the nurse explains that the drug is used in the spinal cord–injured patient to:
1. reduce spinal cord cellular damage. 2. counteract spinal shock. 3. increase blood supply to the injured cord. 4. enhance sexual function.
Information that is CONFIDENTIAL must be _______
(A) shared (B) ignored (C) kept private (D) destroyed (E) forgotten