Diabetes (select all that apply only)

ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply. 1. Increase in pH 2. Comatose state 3. Deep, rapid breathing 4. Decreased urine output 5. Elevated blood glucose level

2,3,5

diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply. 1. Polyuria 2. Shakiness 3. Palpitations 4. Blurred vision 5. Lightheadedness 6. Fruity breath odor

2,3,5 R: Shakiness, palpitations, and lightheadedness are signs/symptoms of hypoglycemia and would indicate the need for food or glucose. Polyuria, blurred vision, and a fruity breath odor are manifestations of hyperglycemia.

Which of the following is an age-related change that may affect diabetes? Select all that apply. A. Taste changes B. Decreased vision C. Increased bowel motility D. Decreased renal function E. Increased proprioception

A,B, and D R: Age-related changes include decreased renal function, taste changes, decreased vision, decreased bowel motility, and decreased proprioception.

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? (Select all that apply.) A. Ketosis-prone B. Obesity at diagnoses C. Little endogenous insulin D. Younger than 30 years of age E. Older than 65 years of age

A,C,D R:Type I diabetes mellitus is associated with the following characteristics: onset any age, but usually young (<30 y); usually thin at diagnosis, recent weight loss; etiology includes genetic, immunologic, and environmental factors (e.g., virus); often have islet cell antibodies; often have antibodies to insulin even before insulin treatment; little or no endogenous insulin; need exogenous insulin to preserve life; and ketosis prone when insulin absent.

A patient is brought to the emergency department by the paramedics. The patient is a type 2 diabetic and is experiencing HHS. The nurse should identify what components of HHS? Select all that apply. A) Leukocytosis B) Glycosuria C) Dehydration D) Hypernatremia E) Hyperglycemia

B,C,D,E R: In HHS, persistent hyperglycemia causes osmotic diuresis, which results in losses of water and electrolytes. To maintain osmotic equilibrium, water shifts from the intracellular fluid space to the extracellular fluid space. With glycosuria and dehydration, hypernatremia and increased osmolarity occur. Leukocytosis does not take place.

Which factors will cause hypoglycemia in a client with diabetes? Select all that apply. A. Client has been sleeping excessively. B. Client has not consumed sufficient calories. C. Client has been exercising more than usual. D. Client is experiencing effects of the aging process. E. Client has not consumed food and continues to take insulin or oral antidiabetic medications.

B,C,E R: Hypoglycemia can occur when a client with diabetes is not eating at all and continues to take insulin or oral antidiabetic medications, is not eating sufficient calories to compensate for glucose-lowering medications, or is exercising more than usual. Excessive sleep and aging are not factors in the onset of hypoglycemia.

Which of the following is a characteristic of diabetic ketoacidosis (DKA)? Select all that apply. A. Absent ketones B. Elevated blood urea nitrogen (BUN) and creatinine C. More common in type 1 diabetes D. Normal arterial pH level E. Rapid onset

B,C, E R:DKA is characterized by an elevated BUN and creatinine, rapid onset, and it is more common in type 1 diabetes. Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is characterized by the absence of urine and serum ketones and a normal arterial pH level.

Exercise lowers blood glucose levels. Which of the following are the physiologic reasons that explain this statement. Select all that apply. A. Decreases total cholesterol B. Increases lean muscle mass C. Increases glucose uptake by body muscles D. Decreases the levels of high-density lipoproteins E. Increases resting metabolic rate as muscle size increases

a,b,c,e, R:All of the options are benefits of exercise except the effect of decreasing the levels of HDL. Exercise increases the levels of HDL.