A 50-year-old client with type 2 diabetes and obesity is sta… | MyMerci
Medical EmergenciesPA
Question
A 50-year-old client with type 2 diabetes and obesity is starting semaglutide 0.25 mg subcutaneous once weekly (titrated). Which teaching is most appropriate?
1Stop the medication immediately if you lose any weight because that means it is working too hard.
2Inject the same dose at the same time of day, 7 days a week, every day.
3Use semaglutide as an immediate rescue agent during severe hypoglycemia.
4Inject once weekly on the same day each week (any time of day, with or without meals); rotate sites (abdomen, thigh, upper arm); expect mild GI side effects (nausea, decreased appetite, diarrhea, constipation) early in titration that usually improve; report severe persistent abdominal pain (possible pancreatitis), neck mass or hoarseness, and avoid the drug if you have a personal or family history of medullary thyroid carcinoma or MEN-2.✓ Correct answer
Key teaching: • Once-weekly SC injection on the same day each week·any time of day·with or without meals·rotate abdomen/thigh/upper arm. • GI side effects:nausea (common), decreased appetite, vomiting, diarrhea, constipation, bloating — peak during titration·usually improve. Eat smaller meals·hydrate·avoid high-fat meals·report severe/persistent. • Pancreatitis warning:severe abdominal pain radiating to back·persistent vomiting → stop·notify provider. • Medullary thyroid carcinoma (MTC) — boxed warning:contraindicated in personal/family history of MTC or MEN-2 (multiple endocrine neoplasia 2)·report neck mass, hoarseness, dysphagia, dyspnea. • Hypoglycemia LOW as monotherapy·increased with insulin/sulfonylurea. • Gallbladder disease·diabetic retinopathy progression (with rapid A1c drop). • Weight loss is an EXPECTED therapeutic effect (positive) — do not stop because of weight loss·titrate per protocol. • Do NOT use for acute hypoglycemia rescue — that is glucagon or D50W.
Key teaching: • Once-weekly SC injection on the same day each week·any time of day·with or without meals·rotate abdomen/thigh/upper arm. • GI side effects:nausea (common), decreased appetite, vomiting, diarrhea, constipation, bloating — peak during titration·usually improve. Eat smaller meals·hydrate·avoid high-fat meals·report severe/persistent. • Pancreatitis warning:severe abdominal pain radiating to back·persistent vomiting → stop·notify provider. • Medullary thyroid carcinoma (MTC) — boxed warning:contraindicated in personal/family history of MTC or MEN-2 (multiple endocrine neoplasia 2)·report neck mass, hoarseness, dysphagia, dyspnea. • Hypoglycemia LOW as monotherapy·increased with insulin/sulfonylurea. • Gallbladder disease·diabetic retinopathy progression (with rapid A1c drop). • Weight loss is an EXPECTED therapeutic effect (positive) — do not stop because of weight loss·titrate per protocol. • Do NOT use for acute hypoglycemia rescue — that is glucagon or D50W.