A patient who takes insulin states, My blood glucose has been low ...

[casperchen82]

A patient who takes insulin states, My blood glucose has been low the last few mornings. Which statement would the nurse evaluate as a possible cause of this change?
 
  1. I have been taking a garlic supplement to prevent colds.
  2. I have been taking St. John's wort to help with my memory.
  3. I have been taking extra vitamin C since so many people have influenza.
  4. I have been taking vitamin D to help build up my bones.

Question 2

Which statement is priority teaching at the time of discharge for the client who receives imipramine (Tofranil)?
 
  1. You will need to maintain a low-fat diet while on this medication.
  2. You must maintain a normal intake of salt while on this medication.
  3. Please notify your healthcare provider of any changes in urine quantity or quality.
  4. You can stop the medication when you are no longer feeling depressed.

[BAOCHAU2803]

Answer to Question 1

1
Rationale 1: Garlic may potentiate the hypoglycemic effect of insulin.
Rationale 2: St. John's wort is not implicated in this change.
Rationale 3: Vitamin C is not implicated in this change.
Rationale 4: Vitamin D is not implicated in this change.

Global Rationale: Garlic may potentiate the hypoglycemic effect of insulin. St. John's wort, vitamin C, and vitamin D are not implicated in this change.

Answer to Question 2

3

Rationale 1:You will need to maintain a low-fat diet while on this medication is incorrect because a low-fat diet, although healthy, has no impact on the effectiveness of the medication.
Rationale 2:You must maintain a normal intake of salt while on this medication is incorrect because salt intake affects lithium, not tricyclic antidepressants.
Rationale 3: Urinary retention is a serious side effect of tricyclic antidepressants, and must be reported to the healthcare provider.
Rationale 4:You can stop the medication when you are no longer feeling depressed is incorrect because depressed clients should not stop their antidepressant medication just because they no longer feel depressed.

Global Rationale: TCAs such as imipramine (Tofranil) have a long half-life, which increases the risk of adverse effects for patient with delayed excretion. Anticholinergic effects, such as dry mouth, constipation, urinary retention, blurred vision, and tachycardia are common. Urinary retention is a serious side effect of tricyclic antidepressants, and must be reported to the healthcare provider.

[casperchen82]

Both answers were spot on, thank you once again

[BAOCHAU2803]

Great! Please up vote