The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)
an upper urinary tract infection
decreased caloric intake
aerobic exercise
clogged tubing of a subcutaneous insulin pump
not taking sufficient insulin
Correct Answer : A,B,D,E
A. Infections, including urinary tract infections, can increase insulin resistance and elevate blood glucose levels, potentially leading to DKA. The stress response from infection can also increase cortisol levels, further contributing to hyperglycemia.
B. Decreased caloric intake can lead to inadequate insulin levels relative to the body’s needs. In Type 1 diabetes, if insulin is not sufficient to metabolize glucose (due to low intake or other reasons), the body may resort to fat metabolism, leading to the production of ketones and the development of DKA.
C. While exercise can affect blood glucose levels, it typically lowers them and is not a direct cause of DKA. In fact, moderate aerobic exercise is usually encouraged for managing diabetes. However, if blood glucose levels are already high before exercise, it may exacerbate the situation, but aerobic exercise itself is not a cause of DKA.
D. Clogged tubing can prevent insulin delivery, leading to insufficient insulin levels. This lack of insulin can result in elevated blood glucose levels and, ultimately, the risk of DKA if not addressed.
E. Not taking enough insulin is a primary cause of DKA in Type 1 diabetes. Without adequate insulin, the body cannot utilize glucose properly, leading to increased fat metabolism and the production of ketones, which can cause DKA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While staying hydrated is essential, especially during illness, limiting intake to non-caloric liquids could lead to inadequate caloric intake and worsen the client’s condition. Instead, the client should maintain a balanced intake of fluids and carbohydrates as tolerated.
B. This is a reasonable approach. Monitoring blood glucose levels regularly allows the client to assess how their body is responding to the illness and any adjustments in insulin. If the levels continue to rise, it is important for the client to seek medical attention to prevent complications like diabetic ketoacidosis (DKA).
C. While it is important to manage carbohydrate intake, completely decreasing carbohydrate intake can lead to inadequate caloric consumption, which is especially risky during an illness. The body needs energy, and people with diabetes must balance carbohydrate intake with insulin administration to avoid complications.
D. Holding insulin can lead to dangerously high blood glucose levels. Clients with Type 1 diabetes require insulin regardless of illness, and it’s crucial to adjust the insulin regimen based on current blood glucose levels and carbohydrate intake.
Correct Answer is A
Explanation
A. The client's fasting blood glucose levels (70-80 mg/dl) are within the normal range, and a post- prandial blood glucose level below 200 mg/dl is also considered well-controlled, particularly for someone on an intensified insulin regimen. The hemoglobin A1c level of 4.5% indicates excellent long- term glucose control, typically representing average blood glucose levels of around 90 mg/dl.
B. Hyperglycemia is characterized by elevated blood glucose levels. Given the client's consistently normal fasting and post-prandial levels, they are not at an increased risk for hyperglycemia. Instead, they are maintaining their glucose levels well.
C. Insulin resistance typically manifests as elevated blood glucose levels despite adequate insulin levels or increased insulin requirements. In this case, the client's blood glucose levels are well-controlled, indicating that they are likely responding well to insulin therapy and are not showing signs of insulin resistance.
D. While the client’s blood glucose levels are well-controlled, the risk for hypoglycemia depends on various factors, including insulin dosage, timing, and food intake. However, consistently normal levels do not directly indicate a risk for hypoglycemia unless insulin doses are excessively high or meals are skipped. Therefore, this choice is not justified given the data provided.
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