For the patient with diabetes mellitus, which microvascular complication of the blood vessel structure may occur? Select all that apply. One, some, or all responses may be correct.

Nephropathy

Neuropathy

Peripheral vascular disease

Cerebral vascular disease

Retinopathy

Answer and Explanation

Correct Answer : A,B,E

Choice A: Nephropathy

Diabetic nephropathy is a common microvascular complication of diabetes mellitus. It is characterized by damage to the small blood vessels in the kidneys, leading to progressive kidney disease. The condition is often identified by the presence of protein in the urine (proteinuria) and can progress to end-stage renal disease if not managed properly. The primary mechanism involves hyperglycemia-induced damage to the glomeruli, the filtering units of the kidneys. This damage results in increased permeability and eventual scarring, impairing kidney function. Effective management of blood glucose levels and blood pressure is crucial in preventing or slowing the progression of diabetic nephropathy.

Choice B: Neuropathy

Diabetic neuropathy refers to nerve damage caused by chronic high blood sugar levels. It is another significant microvascular complication of diabetes. This condition can affect various types of nerves, including sensory, motor, and autonomic nerves. Symptoms may include pain, tingling, numbness, and loss of sensation, particularly in the extremities. Diabetic neuropathy can lead to severe complications such as foot ulcers and infections, which may necessitate amputation. The pathophysiology involves hyperglycemia-induced oxidative stress and inflammation, leading to nerve damage. Tight glycemic control and regular monitoring are essential in managing diabetic neuropathy.

Choice E: Retinopathy

Diabetic retinopathy is a leading cause of blindness among adults with diabetes. This microvascular complication involves damage to the small blood vessels in the retina, the light-sensitive tissue at the back of the eye. There are two main types: non-proliferative and proliferative retinopathy. Non-proliferative retinopathy is characterized by microaneurysms, hemorrhages, and exudates, while proliferative retinopathy involves the growth of new, fragile blood vessels that can bleed and cause retinal detachment. The primary cause is prolonged hyperglycemia, which damages the retinal blood vessels. Regular eye examinations and good glycemic control are vital in preventing and managing diabetic retinopathy.

Choice C: Peripheral Vascular Disease

Peripheral vascular disease (PVD) is not classified as a microvascular complication but rather a macrovascular one. It involves the narrowing or blockage of the blood vessels outside the heart and brain, primarily affecting the arteries in the legs. PVD is associated with atherosclerosis, where plaque builds up in the arterial walls, leading to reduced blood flow. Symptoms include leg pain, cramping, and ulcers. While PVD is a significant concern for individuals with diabetes, it is not considered a microvascular complication.

Choice D: Cerebral Vascular Disease

Cerebral vascular disease, which includes conditions such as stroke and transient ischemic attacks (TIAs), is also a macrovascular complication rather than a microvascular one. It involves the blood vessels supplying the brain and is primarily caused by atherosclerosis and hypertension. Diabetes increases the risk of cerebral vascular disease due to its association with other risk factors like high blood pressure and dyslipidemia. However, it is not classified as a microvascular complication.

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Correct Answer is A

Explanation

Choice A Reason:

Occasional palpitations are a common symptom of supraventricular tachycardia (SVT) with a non-sustained ventricular response. Palpitations are sensations of a rapid, fluttering, or pounding heartbeat, which occur due to the irregular and fast heart rate characteristic of SVT. These palpitations can be intermittent and may vary in intensity, often causing discomfort and anxiety in patients.

Choice B Reason:

Weakness can be associated with SVT, but it is not as specific or common as palpitations. Weakness may occur due to the reduced cardiac output and decreased perfusion to the muscles during episodes of rapid heart rate. However, it is not the primary symptom that nurses would anticipate in patients with SVT.

Choice C Reason:

Shortness of breath is another symptom that can occur with SVT, especially during prolonged episodes. The rapid heart rate can lead to decreased efficiency in blood circulation, causing the patient to feel breathless. While shortness of breath is a significant symptom, palpitations are more directly associated with the diagnosis of SVT.

A. Heart rate B. Respiratory rate C. Heart rhythm D. Cardiac output

Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason: Monitoring the heart rate is crucial when administering amiodarone, as this drug can cause bradycardia (a slower than normal heart rate). Amiodarone affects the electrical conduction system of the heart, and close monitoring helps ensure that the heart rate remains within a safe range. The normal resting heart rate for adults is typically between 60 and 100 beats per minute.

Choice B reason: Respiratory rate monitoring is essential because amiodarone can cause pulmonary toxicity, which may manifest as interstitial pneumonitis or pulmonary fibrosis. Early detection of respiratory changes can help prevent severe complications. The normal respiratory rate for adults is 12 to 20 breaths per minute.

Choice C reason: Monitoring heart rhythm is necessary because amiodarone is used to treat arrhythmias, and it can also cause new arrhythmias or exacerbate existing ones. Continuous ECG monitoring helps detect any abnormal rhythms early, allowing for prompt intervention. Normal sinus rhythm is characterized by a regular rhythm with a rate of 60 to 100 beats per minute.

Choice D reason: Cardiac output monitoring is important because amiodarone can affect the contractility of the heart and overall cardiac function. Cardiac output is a measure of the amount of blood the heart pumps in one minute, and it is crucial for ensuring adequate tissue perfusion. Normal cardiac output ranges from 4 to 8 liters per minute in adults.

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For the patient with diabetes mellitus, which microvascular complication of the blood vessel structure may occur? Select all that apply. One, some, or all responses may be correct.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which symptom will the nurse anticipate in a patient diagnosed with supraventricular tachycardia (SVT) with a non-sustained ventricular response?

Correct Answer is A

Explanation

The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

Correct Answer is ["A","B","C","D"]

Explanation

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