A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Blood glucose level below 40 mg/dL

Malignant hypertension

Cheyne-Stokes breathing

Acetone odor to breath

Answer and Explanation

The Correct Answer is D

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "Have an eye examination once per year." Annual eye examinations are essential for detecting diabetic retinopathy early. Early detection and treatment can help prevent vision loss. This is a key recommendation for managing diabetes-related eye complications.

B. "Examine your feet carefully every day." While daily foot examinations are important for preventing diabetic foot ulcers and other complications, they do not directly address the prevention of retinopathy and nephropathy, which are more related to blood glucose control and vascular health.

C. "Wear compression stockings daily." Compression stockings are used to manage conditions like chronic venous insufficiency and to prevent deep vein thrombosis, but they are not related to the prevention of diabetic retinopathy or nephropathy.

D. "Maintain stable blood glucose levels." Keeping blood glucose levels stable is crucial for preventing both retinopathy and nephropathy. Chronic hyperglycemia is a major risk factor for these complications, and good glycemic control reduces the risk of developing or worsening these conditions. This is also crucial but does not specifically target the complications as precisely as regular eye exams do.

A. "This type of diabetes means that the cells in your pancreas do not produce any insulin." B. "This can be a reversible condition, so we will discuss ways to improve your health." C. "Your HbA1c level of 5.7% or below indicates you have impaired glucose tolerance." D. "Since you still have working beta cells, you can try a diet to lower your blood sugar."

Correct Answer is A

Explanation

A. "This type of diabetes means that the cells in your pancreas do not produce any insulin.": Type 1 diabetes mellitus is characterized by the autoimmune destruction of beta cells in the pancreas, which results in an absolute deficiency of insulin. Patients require insulin therapy for management.

B. "This can be a reversible condition, so we will discuss ways to improve your health.": Type 1 diabetes is not reversible. It is a lifelong condition that requires continuous insulin therapy.

C. "Your HbA1c level of 5.7% or below indicates you have impaired glucose tolerance.": An HbA1c level of 5.7% or below is considered normal or indicative of well-controlled blood glucose levels, not impaired glucose tolerance. Impaired glucose tolerance is typically identified with HbA1c levels from 5.7% to 6.4%.

D. "Since you still have working beta cells, you can try a diet to lower your blood sugar.": In type 1 diabetes, the beta cells are mostly or completely non-functional, meaning dietary changes alone are insufficient. Insulin replacement is necessary.

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A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

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