An older female adult who has diabetes mellitus takes glipizide (Glucotrol) and tells the nurse that her blood sugars have been higher than normal since she began using a vaginal cream for hot flashes
Which is the best intervention for the nurse to implement? a. Ask if she had a fever or infection recently.
b. Verify the expiration date of the medication.
c. Review her diet for increased carbohydrates.
d. Ascertain if the vaginal cream contains estrogen.
D
Feedback
A Incorrect. This is a reasonable task to implement because infection increases the blood sugar of an individual with diabetes mellitus; however, because this woman associated the hyperglycemia with the vaginal cream, the most likely contributor to the problem is the vaginal cream, and it is a good place to start the investigation.
B Incorrect. This is a reasonable task to implement, however, because ineffective medication would not have the desired hypoglycemic effect.
C Incorrect. This is a reasonable task to implement, however, because a glucose load will increase the blood sugar.
D Correct. Vaginal cream prescribed for hot flashes potentially contains estrogen as an active ingredient, because estrogen is effective therapy to reduce hot flashes. Unfortunately, estrogen impairs the hypoglycemic effect of sulfonylurea hypoglycemic medications. If the estrogen therapy continues, the nurse should assist this individual in adjusting her diet and exercise regimen in coordination with her antidiabetic medication to maintain stable blood sugar levels.
You might also like to view...
A patient in the intensive care unit has been NPO, taking nothing by mouth, for several days. The nurse is unable to assess bowel sounds. What should be included in the plan to support this patient's nutritional needs?
1. Maintain NPO status. 2. Prepare to assist with implementation of a large bore venous access device to support total parenteral nutrition. 3. Determine best enteral feeding approach and plan implementation. 4. Begin oral feeding with a diet as tolerated as soon as bowel sounds return.
____________________ are times when rheumatoid arthritis seems to worsen.
Fill in the blank(s) with the appropriate word(s).
The nurse is reviewing the medical record for a postpartum client. Which findings would necessitate the need for the nurse to monitor the client closely for the development of thrombophlebitis? Select all that apply
1. Vaginal birth 2. 25 years of age 3. History of diabetes mellitus 4. Current smoker 5. Laboratory values indicating anemia
Bernice is a 73-year-old grandmother. She complains to her daughter Kate, who is a nurse, about waking up early and not being able to return to sleep. On investigation, Kate finds that her moth-er does not go to bed until after the evening news
Kate suspects that her mother isn't getting enough sleep due to "phase advance." What is the best advice Kate can give her mother to ensure that she gets enough sleep at night? A. Take an afternoon nap. B. Go to bed earlier. C. Go to bed later. D. Take a sleeping aid.