Page 1453 - Saunders Comprehensive Review For NCLEX-RN

b. Obtain a medication history

regarding the medications that the
client is taking currently.
c. Assess vital signs and blood glucose
levels.
d. Instruct the client to recognize the signs
and symptoms of hypoglycemia and
hyperglycemia.
e. Instruct the client to avoid over-the-
counter medications unless prescribed
by the PHCP.
f. Instruct the client not to ingest

alcohol with sulfonylureas.
g. Inform the client that insulin

may be needed during times of
increased stress, surgery, or infection.
h. Instruct the client on the necessity for
compliance with prescribed
medication.
i. Instruct the client about how to take
each specific medication, such as with
the first bite of the meal for
meglitinides and α-glucosidase
inhibitors.
j. Advise the client to wear a MedicAlert
bracelet.

Metformin needs to be withheld

temporarily before and for 48 hours after having any
radiological study that involves the administration of
intravenous contrast dye because of the risk of
contrast-induced nephropathy and lactic acidosis.
The PHCP needs to be consulted for specific
prescriptions.

C. Insulin

1. Insulin acts primarily in the liver, muscle, and adipose
tissue by attaching to receptors on cellular
membranes and facilitating the passage of glucose,
potassium, and magnesium.
2. Insulin is prescribed for clients with type 1 diabetes
mellitus and for clients with type 2 diabetes mellitus
whose blood glucose levels are not adequately

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