Medical Surgical Diabetes #14

Question

A client in the hospital voices concern that the blood glucose monitor may not be working because the blood glucose was 295. After reviewing the medications, the nurse explains which of the following would cause elevated blood glucose?

Answers

  1. Quinidine
    • Rationale:

      This answer is not correct because evidence has shown that there is a slight drop (not elevation) of blood glucose when quinidine is taken. Blood glucose levels should be monitored carefully to assure there is not an unsafe drop if taken with other antidiabetic medications.

  2. Prednisone
    • Rationale:

      This answer is correct because a common side effect of prednisone is increased blood glucose, especially in the diabetic client. Close monitoring of blood glucose is important for the diabetic client with additional needs for insulin or other glucose lowering medications or activity to help maintain normal blood glucose levels.

  3. Atenolol
    • Rationale:

      This answer is not correct because atenolol is a beta blocker and would have a tendency to decrease blood glucose, if anything, because it is blocking the sympathetic nervous system fight or flight response. The fight or flight response (that beta blockers are blocking) will elevate blood pressure, heart rate, increase blood glucose, and dilate bronchioles.

  4. Sulfamethoxazole-trimethoprim
    • Rationale:

      This answer is not correct because sulfamethoxazole-trimethoprim, an antibiotic, taken by a diabetic client may actually decrease blood glucose if taken with certain antidiabetic medications. Otherwise, the antibiotic is not known to elevate the blood glucose on its own.

Overview

Prednisone is a glucocorticoid medication used to decrease inflammation. Prednisone has a common side effect of hyperglycemia, especially in diabetic clients.

Explanation

Learning Outcomes

Prednisone is a glucocorticoid medication used to decrease inflammation. A common side effect of prednisone is increased blood glucose, especially in the diabetic client. Close monitoring of blood glucose is important for the diabetic client with additional needs for insulin or other glucose lowering medications or activity to help maintain normal blood glucose levels.

Test Taking Tip

Remember that medications that often end in “-sone” are glucocorticoids. The medications are very effective in decreasing inflammation in the body but have a number of side effects including increasing blood glucose, weakening bones, decreasing immunity, and thinning skin.

Video Rationale