A client takes empagliflozin for heart failure and is scheduled for surgery with prolonged fasting. Which actions are appropriate? Select all that apply.

Select All That Apply

Choose your responses, then check the answer.

1Verify that empagliflozin is withheld for at least 3 days before the procedure when possible. 2Assess volume status, renal function, oral intake, and other ketoacidosis risk factors. 3Exclude ketoacidosis whenever the blood glucose is below 250 mg/dL. 4Check ketones and acid-base status if nausea, abdominal pain, dyspnea, or malaise occurs. 5Restart therapy only after the client is clinically stable and oral intake has resumed. 6Give an extra dose the night before surgery to preserve the heart-failure benefit. 7Restart empagliflozin in the postanesthesia care unit as soon as the procedure ends, even if the client remains fasting. 8Substitute a different SGLT2 inhibitor during the preoperative hold to preserve the heart-failure benefit.

Explanation

Empagliflozin should be withheld for at least 3 days before surgery with prolonged fasting when possible, and ketoacidosis must be considered even without marked hyperglycemia.

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A client takes empagliflozin for heart failure and is scheduled for surgery with prolonged fasting. Which actions are appropriate? Select all that apply.

Select All That Apply

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