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Chapter 32: Antidiabetic Drugs Test, NPH Insulin, Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Insulin, Antidiabetic Drugs, NPH Insulin, Pharmacology for Nurses: Practical Applications

The insulin order reads, “Give 10 units of NPH insulin and 5 units of regular insulin, subQ, every morning before breakfast.” Choose the proper syringe for this injection.

Correct Answer

Insulin . Syringe

The proper syringe for insulin injection is the insulin syringe, which is marked in units. The other syringes listed are not correct for use with insulin because they are not marked in units.

The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?

Rotate sites within the same location for about 1 week before rotating to a new location.

Give the injection in the same area each time.

Avoid the abdomen because absorption there is irregular.

Choose a different site at random for each injection.

Patients taking NPH insulin injections need to be instructed to rotate sites, but to do so within the same location for about 1 week (so that all injections are rotated in one area—for example, the right arm—before rotating to a new location, such as the left arm). Also, each injection needs to be at least 1/2 to 1 inch away from the previous site.

The nurse is reviewing a patient’s medication list and notes that sitagliptin (Januvia) is ordered. The nurse will question an additional order for which drug or drug class?




Metformin (Glucophage)

Sitagliptin is indicated for management of type 2 diabetes either as monotherapy or in combination with metformin, a sulfonylurea, or a glitazone, but not with NPH insulin.

A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these?

To increase blood glucose levels

To decrease the pancreatic secretion of NPH insulin

To decrease insulin resistance

To increase the pancreatic secretion of insulin

Metformin decreases glucose production by the liver; decreases intestinal absorption of glucose; and improves insulin receptor sensitivity in the liver, skeletal muscle, and adipose tissue, resulting in decreased insulin resistance. The other options are incorrect.

The nurse knows to administer acarbose (Precose), an alpha-glucosidase inhibitor, at which time?

30 minutes after breakfast

30 minutes before breakfast

Once daily at bedtime

With the first bite of each main meal

When an alpha-glucosidase inhibitor is taken with the first bite of a meal, excessive postprandial blood glucose elevation (a glucose spike) can be reduced or prevented.