A nurse is teaching a client with diabetes mellitus who asks, "Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL?" How should the nurse respond?
Glucose is the only fuel used by the body to produce the energy that it needs.
Your brain needs a constant supply of glucose because it cannot store it.
Without a minimum level of glucose, your body does not make red blood cells.
Glucose in the blood prevents the formation of lactic acid and prevents acidosis
The Correct Answer is B
Choice A rationale: Glucose is a primary fuel source, but the body can also use fatty acids and amino acids for energy through metabolic pathways like beta-oxidation and gluconeogenesis. The brain, however, has a high metabolic rate and is highly dependent on glucose as its main energy substrate because fatty acids cannot cross the blood-brain barrier efficiently.
Choice B rationale: The brain is almost exclusively dependent on glucose for its energy needs, as it lacks the ability to store glucose as glycogen and cannot effectively utilize other energy sources like fatty acids. A sustained blood glucose level below the normal range, typically below 60 mg/dL, impairs cerebral function, leading to symptoms like confusion and lethargy.
Choice C rationale: The production of red blood cells, a process called erythropoiesis, occurs primarily in the bone marrow. This process is regulated by the hormone erythropoietin and depends on nutrients like iron, vitamin B12, and folic acid. It is not directly linked to a minimum blood glucose level in the way that brain function is.
Choice D rationale: Lactic acid is produced during anaerobic metabolism when oxygen supply is insufficient, not due to low blood glucose. While severe hypoglycemia can lead to metabolic disturbances, lactic acidosis is typically associated with conditions like shock or certain metabolic disorders, not directly with low blood glucose levels.
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Correct Answer is B
Explanation
Choice A rationale: Glucose is a primary fuel source, but the body can also use fatty acids and amino acids for energy through metabolic pathways like beta-oxidation and gluconeogenesis. The brain, however, has a high metabolic rate and is highly dependent on glucose as its main energy substrate because fatty acids cannot cross the blood-brain barrier efficiently.
Choice B rationale: The brain is almost exclusively dependent on glucose for its energy needs, as it lacks the ability to store glucose as glycogen and cannot effectively utilize other energy sources like fatty acids. A sustained blood glucose level below the normal range, typically below 60 mg/dL, impairs cerebral function, leading to symptoms like confusion and lethargy.
Choice C rationale: The production of red blood cells, a process called erythropoiesis, occurs primarily in the bone marrow. This process is regulated by the hormone erythropoietin and depends on nutrients like iron, vitamin B12, and folic acid. It is not directly linked to a minimum blood glucose level in the way that brain function is.
Choice D rationale: Lactic acid is produced during anaerobic metabolism when oxygen supply is insufficient, not due to low blood glucose. While severe hypoglycemia can lead to metabolic disturbances, lactic acidosis is typically associated with conditions like shock or certain metabolic disorders, not directly with low blood glucose levels.
Correct Answer is D
Explanation
Choice A rationale: The Dawn phenomenon is a morning hyperglycemia that results from the normal circadian release of growth hormone and cortisol. These hormones increase glucose production in the liver, leading to elevated blood glucose levels. Unlike the Somogyi phenomenon, it is not preceded by a nocturnal hypoglycemic episode.
Choice B rationale: Insulin resistance is a physiological condition in which cells fail to respond to the normal actions of insulin. The body's cells do not effectively absorb glucose, leading to elevated blood glucose levels. It is a chronic condition and does not involve an acute nocturnal hypoglycemic event followed by a rebound hyperglycemia.
Choice C rationale: Lipodystrophy is a complication of insulin therapy characterized by changes in subcutaneous fat tissue at injection sites. It can present as either lipoatrophy (denting of the skin) or lipohypertrophy (thickening of the skin). This is a localized skin condition and not a systemic metabolic phenomenon related to blood glucose fluctuations.
Choice D rationale: The Somogyi phenomenon is a rebound hyperglycemia that occurs after an episode of undetected hypoglycemia, typically overnight. The low glucose triggers the release of counter-regulatory hormones (glucagon, epinephrine, cortisol, and growth hormone) which stimulate the liver to release glucose, leading to an elevated morning blood glucose level.
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