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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)?
(Select All that Apply.)

The client admitted with diabetic ketoacidosis (DKA)

The client admitted with sleep apnea

The client admitted with a hypertensive crisis

The client admitted for an exacerbation of Systemic Lupus Erythematosus (SLE)

The client admitted with untreated tuberculosis

The client admitted with cirrhosis secondary to chronic alcohol use

Answer and Explanation

Correct Answer : A,D,E

Choice A Reason:

The client admitted with diabetic ketoacidosis (DKA) is correct. Diabetes is a common cause of peripheral neuropathy, particularly if poorly controlled. Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by high blood sugar levels and ketone accumulation. Prolonged uncontrolled diabetes can lead to nerve damage and peripheral neuropathy.

Choice B Reason:

The client admitted with sleep apnea is incorrect. Sleep apnea is a sleep disorder characterized by pauses in breathing or shallow breathing during sleep. While sleep apnea itself is not typically associated with peripheral neuropathy, underlying conditions such as obesity or diabetes, which are risk factors for sleep apnea, can also increase the risk of peripheral neuropathy.

Choice C Reason:

The client admitted with a hypertensive crisis is incorrect. Hypertension (high blood pressure) is not directly associated with peripheral neuropathy. However, poorly controlled hypertension can lead to vascular complications and contribute to conditions such as atherosclerosis, which may indirectly increase the risk of peripheral neuropathy.

Choice D Reason:

The client admitted for an exacerbation of Systemic Lupus Erythematosus (SLE) is correct. Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect various organs and tissues, including the peripheral nerves. Peripheral neuropathy can occur as a complication of SLE, particularly in cases of active disease or as a result of certain medications used to treat SLE.

Choice E Reason:

The client admitted with untreated tuberculosis is incorrect. Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis. While TB itself is not typically associated with peripheral neuropathy, certain medications used to treat TB, such as isoniazid, can cause peripheral neuropathy as a side effect.

Choice F Reason:

The client admitted with cirrhosis secondary to chronic alcohol use is correct. Chronic alcohol use and cirrhosis can lead to various neurological complications, including peripheral neuropathy. Alcohol-related peripheral neuropathy often presents with sensory symptoms such as tingling, numbness, and pain in the extremities.

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Correct Answer is D

Explanation

Choice A Reason:

Myelogram is not appropriate. This imaging test involves injecting contrast dye into the spinal canal to visualize the spinal cord and nerve roots. While it may help identify certain spinal cord abnormalities, it is not typically used as a primary diagnostic tool for multiple sclerosis.

Choice B Reason:

Brain natriuretic peptide (BNP) is not appropriate. This blood test measures the level of BNP, a hormone produced by the heart, which can be elevated in conditions such as heart failure. It is not used in the diagnosis of multiple sclerosis.

Choice C Reason:

Troponin level is not appropriate. Troponin is a protein released into the bloodstream during a heart attack or other heart-related conditions. This test is used to diagnose heart muscle damage and is not relevant to the diagnosis of multiple sclerosis.

Choice D Reason:

Lumbar puncture is appropriate. Also known as a spinal tap, a lumbar puncture involves collecting cerebrospinal fluid (CSF) from the spinal canal for analysis. In the diagnosis of multiple sclerosis, analysis of CSF can help identify certain abnormalities, such as an elevated level of immunoglobulin G (IgG) or the presence of oligoclonal bands, which are often indicative of inflammation in the central nervous system. Therefore, a lumbar puncture is commonly ordered to assist with the diagnosis of multiple sclerosis.

A. Vasogenic cerebral edema B. Osmotic cerebral edema C. Cellular cerebral edema D. Interstitial cerebral edema

Correct Answer is A

Explanation

Choice A Reason:

Vasogenic cerebral edema is appropriate response. Vasogenic cerebral edema occurs due to disruption of the blood-brain barrier (BBB), leading to leakage of fluid and proteins from the blood vessels into the brain parenchyma. This type of cerebral edema is commonly associated with conditions such as brain tumors, abscesses, and ischemic stroke.

Choice B Reason:

Osmotic cerebral edema is inappropriate response. Osmotic cerebral edema occurs when there is an imbalance of osmotic forces across the blood-brain barrier, leading to the movement of water into the brain cells. This type of cerebral edema can result from conditions such as hyponatremia or the administration of hypertonic solutions.

Choice C Reason:

Cellular cerebral edema is inappropriate response. Cellular cerebral edema involves the swelling of brain cells (neurons and glial cells) due to various insults, such as ischemia, hypoxia, or metabolic disturbances. This type of cerebral edema can occur in conditions such as ischemic stroke or traumatic brain injury.

Choice D Reason:

Interstitial cerebral edema is incorrect response. Interstitial cerebral edema involves the accumulation of fluid within the interstitial spaces of the brain tissue. This type of cerebral edema can occur in conditions such as hydrocephalus, where there is obstruction of cerebrospinal fluid (CSF) flow.

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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)? (Select All that Apply.)

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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)?
(Select All that Apply.)