Severe, persistent abdominal pain radiating to the back — possible pancreatitis; hold drug and report immediately.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A nurse administers a beta-2 agonist bronchodilator to a client. Which finding would the nurse expect as a common adverse effect of this drug class?
Answer: A. Beta-2 agonists such as albuterol can stimulate beta-1 receptors at higher doses and commonly cause tachycardia, tremor, and nervousness. These effects result from sympathetic stimulation. Bradycardia, hypotension, and sedation are not expected; beta agonists tend to raise heart rate and cause stimulation rather than sedation.
Question 2 of 3
A client takes a GLP-1 receptor agonist (for example liraglutide) by subcutaneous injection. Which expected effect should the nurse explain?
Answer: A. GLP-1 receptor agonists enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying, and promote satiety, which often leads to reduced appetite and weight loss. Nausea is a common early side effect. They are not insulin replacements and rarely cause hypoglycemia alone.
Question 3 of 3
A client with severe symptomatic hyperkalemia and ECG changes is being treated emergently. Which medication does the nurse anticipate administering first to protect the heart?
Answer: A. IV calcium gluconate is given first in life-threatening hyperkalemia to stabilize the cardiac membrane and protect against dysrhythmias; it does not lower potassium but buys time. Insulin with dextrose and beta agonists then shift potassium into cells, and sodium polystyrene sulfonate removes it more slowly.
Keep the streak going with more questions like these, each with a full rationale.
What is glp-1 agonists?
They lower glucose by stimulating insulin release, suppressing glucagon, and slowing gastric emptying, which also reduces appetite. Most are subcutaneous injections (some weekly, some daily) and carry a low intrinsic risk of hypoglycemia when used alone.
Key points to remember
- Mechanism: enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying, and increase satiety.
- Promote weight loss and have a low risk of hypoglycemia when used alone (risk rises if combined with insulin or sulfonylureas).
- Most common side effects are GI: nausea, vomiting, diarrhea, which often improve over time.
- Carry a boxed warning for thyroid C-cell tumors (medullary thyroid carcinoma) seen in animal studies.
- Pancreatitis is a serious risk; delayed gastric emptying can affect absorption of oral drugs and increase aspiration risk under anesthesia.
Nursing priorities
- Teach proper subcutaneous injection technique, site rotation, and the specific dosing schedule (daily vs weekly).
- Monitor for GI side effects and advise eating smaller, slower meals to reduce nausea.
- Assess for signs of pancreatitis (severe persistent abdominal pain radiating to the back).
- Review concurrent insulin or sulfonylurea use because hypoglycemia risk increases with these combinations.
Labs & values
Patient teaching
- Inject subcutaneously in the abdomen, thigh, or upper arm and rotate sites.
- Take exactly on schedule; if a weekly dose is missed, follow the package instructions on timing.
- Eat smaller meals and stop when full to reduce nausea and vomiting.
- Report severe stomach pain, a neck lump, or trouble swallowing right away.
- Tell anesthesia/surgical teams you take a GLP-1 agonist because of delayed stomach emptying and aspiration risk.
Red flags: report now
- Severe, persistent abdominal pain radiating to the back — possible pancreatitis; hold drug and report immediately.
- Neck mass, hoarseness, dysphagia, or persistent hoarse cough — possible thyroid tumor; report now.
- Never use in patients with a personal or family history of medullary thyroid carcinoma or MEN 2.
References
Clinical references for this topic
