The nurse manages care for a patient with diabetes who takes ...

[kaid0807]

The nurse manages care for a patient with diabetes who takes metformin. Which laboratory result would cause the greatest concern?
 
  a. Elevated creatinine
  b. Anemia
  c. Decreased platelets
  d. Increased iron

Question 2

An adolescent patient with type 1 diabetes experiences a severe hypoglycemic reaction in the clinic. Before providing orange juice, the nurse should
 
  a. start an IV.
  b. obtain a stat serum calcium level.
  c. check the gag reflex.
  d. consult the dietician.

[jackie]

Answer to Question 1

ANS: A
An increased creatinine level indicates renal dysfunction. This would cause serious concern, because metformin is excreted unchanged by the kidneys, and with renal impairment, metformin can accumulate to toxic levels.
Anemia, decreased platelets, and increased iron are secondary concerns that need to be managed; however, the most significant concern is definitely the increased creatinine level, which signals renal dysfunction.

Answer to Question 2

ANS: C
In case the patient's gag reflex is not intact, it is imperative to assess its function before the oral orange juice is given.
An IV would not be the first action but would be part of this patient's care.
A stat calcium level is not indicated at this time.
The dietician could be contacted to set up some teaching for the patient after this acute crisis has been managed.

[kaid0807]

Excellent

[jomama]

TYSM