The nurse obtains a health history from a client who states, "I skip dinner most nights to lose weight. I don't want to get low blood sugar, so I don't take my evening dose of metformin when I skip dinner." Which response by the nurse is appropriate?

Question

The nurse obtains a health history from a client who states, "I skip dinner most nights to lose weight.  I don't want to get low blood sugar, so I don't take my evening dose of metformin when I skip dinner."  Which response by the nurse is appropriate?

Quizplus · Accepted Answer

Metformin is an oral antidiabetic medication used to manage hyperglycemia in clients with type 2 diabetes. Metformin increases the sensitivity of insulin receptors in cells and reduces glucose production by the liver. These actions increase the efficacy of insulin present in the body and prevent large rises in blood glucose after meals. Because metformin does not stimulate insulin secretion by the pancreas, the risk of hypoglycemia is minimal (Option C). Although skipping meals would cause a drop in blood glucose, metformin would not cause further hypoglycemia. (Option A) Investigating the effect that skipping meals and medication has on the client's blood glucose levels may imply affirmation of the incorrect action. The nurse should provide education about the drug action and appropriate means of weight loss. (Option B) Instructing the client to alter the frequency or dose of prescribed medication is outside of the nurse's scope of practice. Alterations to treatment plans require the prescriptive authority of a health care provider. (Option D) Skipping meals to lose weight is not a healthy weight-loss strategy as it causes cellular energy deficits and may lead to hypoglycemia. Educating the client to take medications as prescribed remains the priority. Furthermore, "Why" questions are not appropriate forms of therapeutic communication. Educational objective: Metformin is an oral antidiabetic medication that increases insulin sensitivity and inhibits liver glucose production. Metformin does not increase insulin secretion, so the risk of hypoglycemia is minimal even when meals are skipped.

The Nurse Obtains a Health History from a Client Who