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 ["B","E","F"]
Explanation
Rationale:
A. The vital signs are stable and within normal limits. The slight drop in blood pressure post-dialysis is expected and not immediately concerning.
B. The client's weight decreased from 90 kg (198 lb) to 86.4 kg (190 lb) after dialysis. While weight loss is expected due to fluid removal during dialysis, this significant decrease (3.6 kg or approximately 8 lb) may need closer monitoring to ensure the client is not becoming dehydrated or losing more fluid than is safe.
C. The blood glucose levels are within an acceptable range for a client with type 2 diabetes mellitus. The slight decrease from 134 mg/dL to 75 mg/dL is not unusual given the time between measurements and the client's food intake.
D. The presence of a bruit and thrill at the AV fistula site indicates that it is functioning correctly, which is an expected finding.
E. The presence of crackles in the left lower lobe and an unproductive cough on the morning of Day 2 is concerning. These symptoms could indicate fluid overload or early signs of pulmonary edema, which require further evaluation and possible intervention.
F. The AV fistula site is noted to be ecchymotic and warm, with a bruit and thrill still present. While a bruit and thrill are expected findings, the ecchymosis and warmth could indicate a developing infection or trauma at the site, which necessitates further follow-up to prevent complications.
Correct Answer is ["C","D","E"]
Explanation
Rationale:
A. Bradycardia is not typically associated with emphysema; tachycardia is more common due to hypoxia.
B. Deep respirations are not a hallmark of emphysema; patients often have shallow, rapid breathing due to decreased lung capacity.
C. A barrel chest is a characteristic sign of emphysema, resulting from hyperinflation of the lungs over time.
D. Clubbing of the fingers can occur due to chronic hypoxia associated with emphysema.
E. Dyspnea, or difficulty breathing, is a primary symptom of emphysema due to the destruction of alveoli and reduced gas exchange.