A patient is diagnosed with the type of diabetes in which the plasma beta cells fail to respond to insulin. Which type of diabetes is this patient experiencing?

Choice A reason: A blood glucose of 750 mg/dL indicates severe hyperglycemia, potentially diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), both life-threatening. Notifying the RN and provider ensures rapid intervention, such as IV insulin and fluids, to correct glucose, acidosis, and dehydration, preventing multi-organ failure or coma.

Choice B reason: Verifying diabetes type is important but not the priority with a glucose of 750 mg/dL. Both type 1 (DKA risk) and type 2 (HHS risk) require urgent treatment for severe hyperglycemia. Delaying action for record review risks worsening metabolic decompensation, making this less urgent.

Choice C reason: Administering sliding scale insulin without provider guidance is unsafe for severe hyperglycemia (750 mg/dL), as it may be insufficient for DKA or HHS. IV insulin and fluid therapy are typically required, and acting independently risks inadequate treatment, delaying critical care and worsening patient outcomes.

Choice D reason: Assessing vital signs is useful but not the priority. Severe hyperglycemia requires immediate medical intervention to correct metabolic derangements. Vital signs may indicate shock or dehydration, but notifying the provider ensures comprehensive management, including diagnostics and treatment, addressing the root cause more effectively.

Choice A reason: Hyperglycemia typically increases appetite (polyphagia) due to cellular starvation, as glucose cannot enter cells effectively without insulin. Decreased appetite is not a hallmark of hyperglycemia and may indicate other issues, like gastrointestinal complications, making this statement incorrect for understanding hyperglycemia manifestations.

Choice B reason: Blurred vision can occur in hyperglycemia due to osmotic swelling of the lens from high glucose levels, but it is not constant ("all of the time"). This statement exaggerates the symptom, indicating a partial misunderstanding, as vision changes are typically temporary and resolve with glucose control.

Choice C reason: Increased thirst (polydipsia) is a classic hyperglycemia symptom. High blood glucose causes osmotic diuresis, leading to dehydration, which stimulates thirst to compensate for fluid loss. This statement reflects accurate understanding of hyperglycemia’s physiological effects on fluid balance and renal function.

Choice D reason: Fruity breath odor is a sign of diabetic ketoacidosis, a complication of severe hyperglycemia, due to ketone production from fat metabolism. This indicates understanding of a critical hyperglycemia manifestation, as it reflects metabolic acidosis requiring urgent intervention, making this statement correct.