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A nurse is assessing a client who has a history of type 2 diabetes mellitus. The nurse should identify which of the following findings as an indication of a microvascular complication?

A.

Coronary artery disease

B.

Retinopathy

C.

Cerebrovascular accident

D.

Hypertension

Answer and Explanation

The Correct Answer is B

Rationale:
A. Coronary artery disease: This is a macrovascular complication of diabetes caused by atherosclerosis affecting large blood vessels, leading to reduced blood flow to the heart and increased risk of myocardial infarction. It does not involve small vessel damage.

B. Retinopathy: Diabetic retinopathy is a classic microvascular complication resulting from damage to the small blood vessels of the retina due to chronic hyperglycemia. Over time, it can lead to vision impairment and blindness if not managed appropriately.

C. Cerebrovascular accident: A stroke is considered a macrovascular complication involving large arteries that supply the brain. Diabetes increases the risk through mechanisms such as endothelial dysfunction and accelerated atherosclerosis.

D. Hypertension: Hypertension is a common comorbidity in people with diabetes and contributes to both micro- and macrovascular complications, but it is not itself classified as a direct microvascular complication of diabetes.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

Explanation

Rationale:

  • Troponin I level: An elevated troponin I level indicates myocardial cell injury and is a key diagnostic marker for MI. Even a value at the upper limit of normal (0.03 ng/mL) warrants concern, especially with accompanying symptoms.
  • ECG result – sinus tachycardia: Sinus tachycardia is nonspecific but may occur in both MI and angina due to pain, anxiety, or sympathetic stimulation. However, more definitive MI-related changes like ST elevation or Q waves would provide clearer diagnostic value.
  • Heart rate: A heart rate of 116/min is elevated and may represent the body’s response to pain, hypoxia, or stress. This can be seen in both angina and MI, though persistent or worsening tachycardia in MI may indicate hemodynamic instability.
  • Heart palpitations: Palpitations are common during episodes of angina and are often due to increased sympathetic tone or transient arrhythmias. They are usually mild and resolve with rest or nitroglycerin in stable angina.
  • Blood pressure: A blood pressure of 158/92 mm Hg indicates hypertension, a known trigger and risk factor for angina. Elevated BP increases myocardial oxygen demand, potentially precipitating chest pain in those with coronary artery disease.

Correct Answer is C

Explanation

Rationale:
A. Increased pigmentation: Triamcinolone, a topical corticosteroid, is not known to cause increased skin pigmentation. In some cases, prolonged use can lead to hypopigmentation, especially in clients with darker skin tones.

B. Localized hair loss: Hair loss is not commonly associated with triamcinolone use. In fact, some corticosteroids may lead to localized hair growth due to their effects on the skin and follicles.

C. Thinning of the skin: Prolonged use of topical corticosteroids like triamcinolone can lead to skin atrophy. This manifests as thinning of the skin, increased fragility, and a higher risk of bruising or tearing with minimal trauma.

D. Increased sensitivity to the sun: Photosensitivity is not a typical side effect of triamcinolone. Sun protection is generally recommended for healthy skin care, but triamcinolone does not specifically increase sun sensitivity.

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