Adverse Drug Reactions
Hypoglycemia |
Nausea, Vomiting |
Nursing Interventions
Monitor for signs of hypoglycemia (diaphoresis, tachycardia, fatigue, excessive hunger, tremors). |
If the client is conscious, give glucose orally in either pill form, glass of orange juice, 2–3 tsp of sugar, honey, or corn syrup dissolved in water. |
If the client is not conscious, give intravenous glucose; give parenteral glucagon if IV not available |
Check the client’s blood glucose every 15–20 minutes. |
Continue treatment until the blood glucose has returned to the expect- ed reference range and the client is no longer symptomatic. |
Monitor for persistent nausea, vomiting, or diarrhea. |
Monitor CBC levels |
Drug Administration
Give orally 30 min or less before meals, usually three times a day |
Tell clients to skip a dose if they skip a meal and to add a dose if they add a meal. |
Do not exceed 4 doses a day. |
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Patient Education
Wear a medical alert bracelet. |
Watch for and report symptoms of hypoglycemia. |
Test blood glucose to confirm. |
If hypoglycemia occurs, advise patient to take a glass of orange juice or 2–3 tsp of sugar, honey, or corn syrup dissolved in water (glucose, not table sugar, if taking miglitol), and notify health care professional. |
Retest in 15 to 20 min and repeat treatment if still low. |
Carry a carbohydrate snack at all times. |
Lie down when feeling nauseated. |
Consume adequate carbohydrates. |
Contraindications
Diabetic ketoacidosis |
Liver, kidney, and endocrine disorders |
Precautions
Renal or hepatic dysfunction |
Systemic infection |
Older adults |
Use of alcohol, NSAIDs, warfarin, loop diuretics, and anabolic steroids |
Interactions
Gemfibrozil (Lopid), erythromycin, and chloramphenicol increase hypo- glycemic effects. |
Alcohol, corticosteroids, and rifampin decrease hypoglycemic effects. |
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