The nurse reads the chart for a client with diabetes. The chart indicates 'history of autonomic neuropathy.' The nurse knows that autonomic neuropathy may cause which symptoms?

Burning pain and tingling in extremities

Nausea and feeling of abdominal fullness

Elevated blood pressure and delayed capillary refill

Increased thirst and excessive urination

Answer and Explanation

The Correct Answer is B

Choice A reason: Burning pain and tingling in extremities are not symptoms of autonomic neuropathy, but of peripheral neuropathy. Peripheral neuropathy affects the sensory and motor nerves that innervate the skin, muscles, and joints. It can cause pain, numbness, weakness, and loss of sensation in the extremities. Autonomic neuropathy affects the nerves that control the involuntary functions of the body, such as digestion, blood pressure, heart rate, and sweating.

Choice B reason: Nausea and feeling of abdominal fullness are symptoms of autonomic neuropathy, specifically of gastroparesis. Gastroparesis is a condition where the stomach muscles are weakened or paralyzed, and cannot move food properly. It can cause delayed gastric emptying, nausea, vomiting, bloating, early satiety, and poor blood glucose control. Autonomic neuropathy can damage the vagus nerve, which regulates the stomach motility and secretion.

Choice C reason: Elevated blood pressure and delayed capillary refill are not symptoms of autonomic neuropathy, but of cardiovascular problems. Blood pressure is the force of blood against the walls of the arteries, and capillary refill is the time it takes for the color to return to the nail bed after pressing on it. Elevated blood pressure can indicate hypertension, which is a risk factor for heart disease and stroke. Delayed capillary refill can indicate poor blood circulation, which can be caused by atherosclerosis, peripheral artery disease, or shock. Autonomic neuropathy can affect the blood pressure and heart rate, but usually causes hypotension and tachycardia, not hypertension and delayed capillary refill.

Choice D reason: Increased thirst and excessive urination are not symptoms of autonomic neuropathy, but of diabetes mellitus. Diabetes mellitus is a condition where the body cannot produce or use insulin properly, and the blood glucose level becomes too high. Increased thirst and excessive urination are signs of hyperglycemia, which is a high blood glucose level. Hyperglycemia can cause dehydration, electrolyte imbalance, and ketoacidosis. Autonomic neuropathy can be a complication of diabetes mellitus, but it does not cause increased thirst and excessive urination.

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Correct Answer is C

Explanation

Choice A reason: This statement is false. IV morphine sulfate is a pain medication that can be given as needed to the postoperative patient. It does not affect the serum sodium level.

Choice B reason: This statement is false. Dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can be used to treat hyponatremia, or low serum sodium level. It provides both glucose and sodium to the patient.

Choice C reason: This statement is true. 5% dextrose in water is a hypotonic solution that can cause further dilution of the serum sodium level. It can worsen the hyponatremia and increase the risk of cerebral edema and seizures.

Choice D reason: This statement is false. Neurologic assessment Q2 hours is a necessary intervention for a patient with hyponatremia, as it can monitor for signs of neurologic deterioration such as confusion, lethargy, or coma.

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Correct Answer is A

Explanation

Choice A reason: Metabolic acidosis is a condition where the blood pH is lower than normal, due to an excess of acids or a loss of bases in the body. Jo is most at risk of developing metabolic acidosis, because of the high blood glucose level. High blood glucose can cause diabetic ketoacidosis, a complication of Type 1 Diabetes, where the body breaks down fat for energy and produces ketones, which are acidic substances. Ketones can accumulate in the blood and lower the pH, causing symptoms such as nausea, vomiting, abdominal pain, fruity breath, and confusion.

Choice B reason: Metabolic alkalosis is a condition where the blood pH is higher than normal, due to an excess of bases or a loss of acids in the body. Jo is not likely to develop metabolic alkalosis, because of the high blood glucose level. Metabolic alkalosis can be caused by conditions such as vomiting, diuretic use, or excessive antacid intake, which can increase the bicarbonate level or decrease the chloride level in the blood. These conditions are not related to Jo's diabetes.

Choice C reason: Respiratory acidosis is a condition where the blood pH is lower than normal, due to an accumulation of carbon dioxide in the body. Jo is not prone to developing respiratory acidosis, because of the high blood glucose level. Respiratory acidosis can be caused by conditions that impair the lung function, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia, which can reduce the ventilation and increase the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.

Choice D reason: Respiratory alkalosis is a condition where the blood pH is higher than normal, due to a loss of carbon dioxide in the body. Jo is not susceptible to developing respiratory alkalosis, because of the high blood glucose level. Respiratory alkalosis can be caused by conditions that increase the breathing rate, such as anxiety, fever, or hyperventilation, which can reduce the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.

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The nurse reads the chart for a client with diabetes. The chart indicates 'history of autonomic neuropathy.' The nurse knows that autonomic neuropathy may cause which symptoms?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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