Ch 25 Short-term Complications of Diabetes quiz

Question 4 of 5 Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box. Hyperosmolar Hyperglycemia Syndrome More common in type 1 than in type 2 diabetes Presence of insulin blocks ketone formation Elevated blood glucose ≥ 600 mg/dL Low risk for dehydration Blood osmolarity ≥ 320 mOsm/L Extremely acidic pH (<7.2) Infection is precipitating factor

Blood osmolarity ≥ 320 mOsm/L Presence of insulin blocks ketone formation Elevated blood glucose ≥ 600 mg/dL Infection is precipitating factor CORRECT. HHS is a major short-term complication of type 2 diabetes. The body produces insulin, but the cells are resistant to insulin. Hyperglycemia results. At the same time, cells are not absorbing glucose and sense starvation. However, endogenous insulin counteracts lipolysis, preventing ketone formation. Additionally, elevated serum glucose results in increased osmotic pressure. Clinical manifestations include dehydration, tachycardia, confusion, polydipsia, polyuria and hypotension. Precipitating factors include infection and noncompliance with diet or medication.

Question 2 of 5 Which of the following statements about the Somogyi effect and dawn phenomenon are correct? Select all that apply. Both the Somogyi effect and dawn phenomenon are associated with morning hyperglycemia. Nocturnal hypoglycemia occurs in the Somogyi effect, but not the dawn phenomenon. Morning hypoglycemia occurs in both the Somogyi effect and dawn phenomenon. Growth hormone elevation at night contributes to the dawn phenomenon. In the Somogyi effect and dawn phenomenon, blood glucose levels spike after mid-day.

Both the Somogyi effect and dawn phenomenon are associated with morning hyperglycemia. Nocturnal hypoglycemia occurs in the Somogyi effect, but not the dawn phenomenon. Growth hormone elevation at night contributes to the dawn phenomenon.

Primary signs of diabetes mellitus Polyuria Hyperglycemia Polyphagia Polydipsia

CORRECT. The three polys—polyphagia, polydipsia, and polyuria—are common presenting signs of diabetes mellitus. Blood glucose less than 70 mg/dL is indicative of hypoglycemia. Diabetes mellitus is a condition of hyperglycemia.

Question 5 of 5 Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box. Hypoglycemia Only occurs in individuals with type 1 diabetes May result from excess insulin Inhibits the release of epinephrine and glucagon Activates the sympathetic nervous system Can occur in type 1 and type 2 diabetes Treatments include glucose tablets and/or fruit juice

Can occur in type 1 and type 2 diabetes Activates the sympathetic nervous system May result from excess insulin Treatments include glucose tablets and/or fruit juice CORRECT. Hypoglycemia can occur in type 1 or type 2 diabetes. Factors such as too much insulin, poor timing of insulin, too little food intake, illness, physical activity and stressors can cause blood glucose levels to decline. The body responds by releasing epinephrine, glucagon, and cortisol and by activating the sympathetic nervous system. This response causes the signs and symptoms of hypoglycemia, such as sweating, dizziness, confusion, hunger and heart palpitations. To manage hypoglycemia, some form of glucose is needed (e.g., glucose tablets, fruit juice, regular soft drink, hard candy).

Question 3 of 5 Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box. Diabetic Ketoacidosis More common in type 1 than in type 2 diabetes Caused by a lack or too little insulin May result in "fruity" smelling breath Results from too much insulin Blood pH < 7.3 Results from hypoglycemia Glucose available, but body cannot use it Increased ketone formation Decreased lipolysis Gradual onset (weeks to years)

Caused by a lack or too little insulin Blood pH < 7.3 Increased ketone formation Glucose available, but body cannot use it May result in "fruity" smelling breath More common in type 1 than in type 2 diabetes CORRECT. When someone with type 1 diabetes forgets to take insulin or does not take enough insulin, blood glucose rises. The body cannot use the glucose and perceives starvation, and begins lipolysis, which leads to ketone formation. As ketones accumulate in the blood, the blood becomes acidic, leading to clinical manifestations, including breath that smells fruity, Kussmaul respirations, signs of dehydration, the three "polys," and nausea and vomiting.

Question 5 of 5 Which sign or symptom would you expect patients with hyperosmolar hyperglycemic syndrome to display? Extremely low blood glucose levels Dehydration Decreased urination Decreased serum osmolarity Elevated blood pressure

Dehydration

Question 4 of 5 A patient arrives with the diagnosis of diabetic ketoacidosis. Which of the following are associated with diabetic ketoacidosis? Select all that apply Elevated serum ketones Decreased blood pH More common in type 1 diabetes Kussmaul's respirations Acetone-smelling breath

Elevated serum ketones Decreased blood pH More common in type 1 diabetes Kussmaul's respirations Fruity-smelling breath

Question 1 of 5 Which of the following scenarios may result in hypoglycemia? Select all that apply. Excess insulin Recent carbohydrate ingestion Insufficient insulin Increased physical activity Insufficient carbohydrate intake

Excess insulin Insufficient carbohydrate intake

Treatment of short-term complications of diabetes mellitus Fluid replacement in both DKA and HS IV insulin treatment in both DKA and HHS Potassium supplementation in DKA treatment Candy or other high-sugar substances provided Wait and see approach IV mannitol solution for both DKA and HHS

Fluid replacement in both DKA and HS IV insulin treatment in both DKA and HHS Potassium supplementation in DKA treatment CORRECT. In both DKA and HHS, blood glucose levels are highly elevated. IV insulin is given to reduce blood glucose. Fluid replacement is needed in both DKA and HHS. Both DKA and HHS are medical emergencies. Cellular dehydration is often present, so IV mannitol should not be given as this pulls water from the intracellular fluid. As DKA and HHS are hyperglycemic conditions, candy should not be provided.

Question 3 of 5 Hyperglycemia may result in which of the following? Select all that apply. Increased serum osmolarity Decreased kidney filtration of glucose Decreased urination Shift of intracellular fluid into extracellular fluid Suppression of thirst mechanism

Increased serum osmolarity Shift of intracellular fluid into extracellular fluid

Question 2 of 5 Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box. Somagyi Effect Morning hyperglycemia Elevated blood glucose level between 2:00 a.m. and 4:00 a.m. Nocturnal hypoglycemia Increased risk with insulin therapy

Nocturnal hypoglycemia Morning hyperglycemia Increased risk with insulin therapy May result from nighttime peaking of insulin CORRECT. With Somagyi effect, excessive insulin dosage or peaking of insulin at night cause hypoglycemia. The body activates several mechanisms to counteract the hypoglycemia (hepatic breakdown of glycogen, gluconeogenesis, and release of epinephrine, cortisol and growth hormone). These mechanisms raise blood glucose, resulting in morning hyperglycemia.

Question 1 of 5 Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box. Dawn Phenomenon Growth hormone peaks in the evening Limited endogenous insulin is present Nocturnal hypoglycemia Normal to high blood glucose level between 2:00 a.m. and 4:00 a.m. Morning hypoglycemia

Normal to high blood glucose level between 2:00 a.m. and 4:00 a.m. Exogenous insulin is not primary cause. Growth hormone peaks in the evening CORRECT. In dawn phenomenon, peaking of growth hormone at night affects cell use of glucose, which is compounded by limited endogenous insulin. This results in morning hyperglycemia. With dawn phenomenon, there is no nocturnal hypoglycemia.

Question 5 of 5 A nurse is caring for a patient with type 2 diabetes. During a follow-up visit, the nurse finds that the patient has developed hyperosmolar hyperglycemia syndrome. Which symptoms in the patient support the nurse's conclusion? Select all that apply. Dizziness Mild hyperglycemia Kussmaul's respirations Ketoacidosis Serum hyperosmolarity

Serum hyperosmolarity

Question 1 of 5 Which of the following are signs and symptoms of hypoglycemia? Select all that apply. Sweating Dizziness Confusion Hunger Heart palpitations

Sweating Dizziness Confusion Hunger Heart palpitations

Question 2 of 5 The Somogyi effect results in morning __________________ following nocturnal _______________. hyperglycemia, hypoglycemia hyperglycemia, hyperglycemia hypoglycemia, hypoglycemia hypoglycemia, hyperglycemia

hyperglycemia, hypoglycemia

Question 4 of 5 Elevated ketone formation ______________________. results from carbohydrate metabolism. may reduce the respiratory rate. occurs more commonly in type 2 diabetics. occurs when lipolysis is suppressed. may cause a decrease is serum pH.

may cause a decrease is serum pH.

Question 3 of 5 Which of the following "poly's" are related to hyperglycemia? Select all that apply. polycythemia polyphagia polyuria polymyalgia polydipsia

polyphagia polyuria polydipsia