A nurse in a provider’s office is collecting data from an older adult client who has type 2 diabetes mellitus. Which of the following findings is a manifestation of hyperglycemia?

Choice A Reason:

Adrenal insufficiency, also known as Addison’s disease, is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Symptoms typically include fatigue, weight loss, low blood pressure, and hyperpigmentation of the skin. High levels of ACTH are not associated with adrenal insufficiency; instead, ACTH levels are usually elevated in response to low cortisol levels.

Choice B Reason:

Pheochromocytoma is a rare tumor of the adrenal gland that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and headaches. It does not cause high levels of ACTH or the physical manifestations described in the patient, such as facial rounding and purple striae.

Choice C Reason:

Cushing Disease is caused by a pituitary adenoma that secretes excess adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. This results in symptoms such as facial rounding (moon face), central obesity, purple striae on the abdomen, and high levels of ACTH. These clinical features align with the patient’s presentation, making Cushing Disease the most likely underlying cause.

Choice D Reason:

Hyperthyroidism is characterized by excessive production of thyroid hormones, leading to symptoms such as weight loss, heat intolerance, palpitations, and tremors. It does not cause high levels of ACTH or the specific physical changes seen in Cushing Disease.

Choice A Reason:

Prescription glasses can help improve vision in the early stages of cataracts by compensating for changes in the lens. However, they do not treat the underlying condition. As cataracts progress, glasses become less effective, and surgery becomes necessary to restore clear vision.

Choice B Reason:

Laser therapy is not used to dissolve cataracts. Instead, it is sometimes used after cataract surgery to treat a condition called posterior capsule opacification, which can occur months or years after the initial surgery. This procedure, known as YAG laser capsulotomy, helps to clear the vision but does not address the primary cataract.

Choice C Reason:

Anti-inflammatory eye drops can be used to manage inflammation and discomfort associated with cataracts or cataract surgery. However, they do not treat or remove the cataract itself. These drops are often part of the post-operative care following cataract surgery.

Choice D Reason:

Cataract surgery is the most effective treatment for cataracts. During the procedure, the clouded natural lens is removed and replaced with a clear artificial lens called an intraocular lens (IOL). This surgery significantly improves vision and is considered the definitive treatment for cataracts.