A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?
Coffee
Milk
Alcohol
Grapefruit juice
The Correct Answer is C
Rationale:
A. Coffee does not interact with glimepiride.
B. Milk is not contraindicated with glimepiride.
C. Alcohol should be avoided while taking glimepiride, as it can potentiate the hypoglycemic effects of the medication and may increase the risk of a severe drop in blood sugar levels.
D. Grapefruit juice is not known to have a significant interaction with glimepiride.
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Correct Answer is A
Explanation
Rationale:
A. A rapid weight gain, such as a 5 lb increase in one day, is a strong indicator of fluid overload, particularly in clients with end-stage kidney disease. This excess fluid retention can lead to complications like pulmonary edema and congestive heart failure.
B. An oxygen saturation of 93% is slightly low but not a direct indicator of fluid overload; it may be related to other factors like anemia or underlying lung disease.
C. Normal skin turgor, where the skin returns to its previous position after being pinched, does not indicate fluid overload. In fluid overload, you might see pitting edema, where the skin does not return immediately.
D. Flattened neck veins would suggest a lack of fluid, not an overload. In fluid overload, you would expect to see distended neck veins (jugular venous distension).
Correct Answer is ["A","C","D","E"]
Explanation
Rationale:
A. The nurse should inform the client that if the stockings are too tight, they may impair blood flow rather than prevent it, which could increase the risk of complications such as pressure sores or circulatory issues.
B. While the stockings should be removed periodically, removing them only once daily for 30 minutes may not be sufficient for skin inspection and care. Best practice usually involves removing them more frequently, such as every 8 hours, to check for skin integrity.
C. Proper skin hygiene and regular assessment should be performed each time the stockings are removed to ensure there is no irritation, breakdown, or circulatory impairment.
D. Antiembolism stockings are designed to be worn both in and out of bed to maintain consistent pressure on the legs and reduce the risk of deep vein thrombosis (DVT).
E. Proper measuring of the leg is crucial to ensure that the stockings fit correctly, providing the necessary compression without being too tight or too loose.