What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (SELECT ALL THAT APPLY)

mental status = lethargic, oriented X 3 but unsure of reason for presenting for care

arterial blood gas pH 7.47/ pCO2-40/HCO3-33/ pa02 = 95

arterial blood gas pH=7.31/pCO2-34/HCO3-17/pa02=98

heart rate=52, regular

respiratory rate = 31, deep

Answer and Explanation

Correct Answer : A,C,E

A.   Lethargy can occur in DKA due to the effects of hyperglycemia, acidosis, and dehydration. Even if the client is oriented, confusion about the reason for care suggests an altered mental state, which can be common in DKA.
B.   This ABG indicates alkalosis (pH > 7.45), which is not typical for DKA. In DKA, we would expect a lower pH (acidosis). This set of values does not align with the expected clinical picture of DKA.
C.   This ABG shows a pH of 7.31, indicating acidosis. The low HCO3 (17) supports metabolic acidosis, which is characteristic of DKA. This finding is consistent with the expected laboratory results in a patient experiencing DKA.
D.   A heart rate of 52 (bradycardia) is not a common finding in DKA. In fact, tachycardia (elevated heart rate) is typically observed due to dehydration and compensatory mechanisms. Bradycardia would not be expected in this context.
E.   A respiratory rate of 31, particularly if deep (known as Kussmaul respirations), is a classic sign of metabolic acidosis, including DKA. Kussmaul respirations are the body’s attempt to compensate for acidosis by increasing carbon dioxide elimination.

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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.

A. access to fresh fruits and vegetables B. living in a disadvantaged community C. having adequate health insurance D. viral infection E. autoimmune disorder

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

Explanation

A. Limited access to fresh fruits and vegetables can contribute to poor dietary habits, which are linked to obesity and diabetes. Communities with food deserts often have higher rates of diabetes due to reduced access to nutritious food, leading to diets high in processed and unhealthy foods.
B. Living in disadvantaged communities is associated with increased diabetes prevalence and complications. Factors such as lower socioeconomic status, limited access to healthcare, poor health education, and environmental stressors can exacerbate health issues, including diabetes.
C. Having adequate health insurance is generally correlated with better health outcomes, including access to preventive care, regular monitoring, and treatment for diabetes. It does not contribute to increased prevalence or complications; rather, it mitigates them.

D. While certain viral infections have been studied for their potential role in triggering autoimmune diabetes (such as Type 1 diabetes), viral infections themselves are not a social inequity and do not directly correlate with increased diabetes prevalence in the same way that socioeconomic factors do.
E. Autoimmune disorders can be associated with Type 1 diabetes and some cases of Type 2 diabetes; however, this option does not reflect a social inequity. Instead, autoimmune disorders are more related to individual health conditions and genetics.

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What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

The client diagnosed with Type I diabetes calls the clinic with a blood glucose level of 285 mg/dL and symptoms of a sore throat, cough, and fever. The clinic triage nurse advises the client to:

Correct Answer is B

Explanation

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

Explanation

What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (SELECT ALL THAT APPLY)

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