Patho Final (work in progress)
A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by a participant should the nurse follow up first?
"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal." In people with diabetes, lesions of the feet represent the effects of neuropathy and vascular insufficiency and are a clinical priority.
A client is admitted to a rehabilitation center after hospital treatment for an ischemic stroke. What aspects of the client's history are risk factors for ischemic stroke? Select all that apply.
- Black male - blood pressure historically in the range of 150/90 to 160/100 mm Hg -Diagnosed with type 2 diabetes 8 years ago Being of black race, male gender, having HTN, and having diabetes are all well-documented risk factors for stroke.
The nurse knows that which client is most likely to exhibit clinical manifestations of chronic fatigue?
A client with a diagnosis of multiple sclerosis who has been admitted to the hospital for exacerbation of the disease process.
Which client is at risk for developing acute respiratory failure?
A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has pneumonia with low O2 ALS is a neurodegenerative disease with various causes. It is characterized by rapidly progressive weakness due to muscle atrophy and muscle spasticity and difficulty in speaking (dysarthria), swallowing (dysphagia), and breathing (dyspnea).
A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?
A tonic-clonic seizure A tonic-clonic seizure often begins with tonic contraction of the muscles with extension of the extremities and immediate loss of consciousness
A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of
An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve
A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis. What assessments and interventions should the nursing staff of the unit prioritize in their care?
Assessment of swallowing ability and respiratory status.
Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease?
Bradykinesia The cardinal symptoms of Parkinson disease are tremor, rigidity (hypertonicity), and bradykinesia (slowness of movement).
Regarding the pathophysiology of Parkinson disease, which statement is true?
Degeneration of the nigrostriatal dopamine neurons occurs.
A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be
Glycosylated hemoglobin, hemoglobin A1C (HbA1C)
The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?
Goals of care for clients with DKA include administration of insulin and intravenous fluid and electrolyte replacement solutions. A common reason for development of DKA is an infection; monitoring for a fever should not take priority over administration of insulin and fluid replacement.
Which maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia
Maternal diabetes women with GDM have an increased risk of developing DM 2
A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?
Psychological manifestation due to involvement of white matter of cerebral cortex
A nurse at a long term care facility provides care for an 85 year-old man who has had recent transient ischemic attacks (TIAs). Which statement best identifies future complications associated with TIAs?
TIAs resolve rapidly but may place the client at an increased risk for stroke.
A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume?
The client is achieving normal glycemic control. The reading for the FBS is appropriate (<100 mg/dL [5.55 mmol/L] is normal) and the hemoglobin A1C level (<6.5) shows good control of glucose levels over a 6- to 12-week period. This client should continue his current exercise and diet routine, which is working well for him.
An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?
The client's blood pressure has historically been in the range of 150/90 to 160/100 mm Hg
During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?
The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction The pathophysiology of MS involves demyelination and subsequent degeneration of nerve fibers in the central nervous system (CNS), marked by prominent lymphocytic invasion in the lesion.
The nurse is teaching a newly diagnosed client with diabetes about fingerstick blood glucose testing. When the client obtains a premeal fingerstick reading of 206 mg/dL (11.43 mmol/L), which teaching by the nurse is most appropriate?
This is an elevated reading - let's talk about adherence to insulin and diet. Normal fasting or pre-meal blood glucose levels are between 70 and 110 mg/dL (3.9 to 6.1 mmol/L). The nurse should ensure the client understands the diet and medication regimen, as diabetes is a self-managed disease; maintaining good glucose control can prevent complications of the disease.
A client with a new diagnosis of type 2 diabetes mellitus states, "I am really worried that I might need to take injections. Is there something I can do to avoid that?" What is the best response by the nurse?
You could regulate your diet, exercise regularly, and lose weight. Diabetes management is based on dietary regulation, exercise, and medications. Many clients with type 2 diabetes mellitus can avoid injections if they exercise regularly, follow dietary guidelines, and manage their weight.
The nurse caring for a client with an aneurysmal subarachnoid hemorrhage understands that the most common cause of this condition is:
berry aneurysm Aneurysmal subarachnoid hemorrhage is a type of hemorrhagic stroke caused by the rupture of a cerebral aneurysm and resultant bleeding into the subarachnoid space. Most of these aneurysms are small, saccular aneurysms called berry aneurysms.
The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?
beta cells
A client with type 1 diabetes has started a new exercise routine. Knowing there may be some ⬆️ risks associated with exercise, the health care provider should encourage the client to
carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.
thrombotic
caused by thrombosis or blood clot blocking a vessel
The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced
generalized seizure.
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes
inspect feet daily for blisters A client with neuropathy is at risk for damage to his or her feet, such as blisters or ulcers, as the clients are unable to feel this damage. Clients need to inspect their feet daily, wear foot coverings (such as closed-toe shoes) to prevent injuries, and continue the exercise patterns to promote improved circulation.
ischemia
interruption of O2 & glucose deliver, waste removal, no perfusion
Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:
is morbidly obese (defined as greater than 100 pounds over ideal weight).
The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be
lumbar puncture
What are the hallmark signs of diabetes mellitus?
polyuria, polydipsia, polyphagia