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Unformatted text preview: diabetic control. What
range of blood glucose should she be advised to aim
for? Case Study
5. Donna needs to understand the signs and symptoms of
hypoglycemia so that she can quickly intervene to prevent
life-threatening complications. How can she recognize
hypoglycemia and what should she do when it occurs?
6. Donna’s health care provider plans to routinely monitor
glycosylated hemoglobin levels (HbAM1c). What information
can be gained from this laboratory test?
7. Donna should be aware of the potential acute and longterm complications of diabetes mellitus. What are they? Case Study
A 58-year-old man with long-standing insulin-treated type 2
diabetes has been diagnosed with right lower extremity
cellulitis. He has taken a prescribed oral antibiotic for the
past week but has not noticed much improvement. For the
last 2 days, he has complained of intermittent fevers and
chills, nausea with poor oral intake, and proximally spreading
erythema over his right leg. On the evening of admission, a
friend notices that he is markedly confused and calls 911. In
the emergency room, he is oriented only to his name. Is
tachypneic, breathing deeply at a rate of 24/min. He is febrile
at 38.8°C. His blood pressure is 120/80, but his heart rate is
elevated at 112 bpm.
On examination, this patient is a delirious, unkempt man with a
fruity breath odor. His right lower extremity is red and tender
to palpation. Serum chemistries reveal glucose of 488
mg/dL. Urine dipstick is positive for ketones.
mg/dL. Case Study
1. Describe the causes of ketoacidosis in this
2. What is the cause of his altered mental
3. Describe the patient's respiratory pattern.
What is the pathophysiological
mechanism? Example Test
Questions Signs and symptoms of hypoglycemia
include all of the following except:
include A. pallor
D. altered consciousness Exercise for the patient with Type II
diabetes may result in:
A. improved renal function
B. decreased insulin resistance
C. decreased risk of eating disorder
D. increased low-density lipid levels Early diabetic nephropathy can be
Microalbuminuria Which of the following indicators is most helpful
in evaluating long-term blood glucose
management in patients with diabetes mellitus? a. Blood glucose levels
b. Urine glucose levels
c. Glycosylated hemoglobin levels
d. Clinical manifestations of hyperglycemia Which of these patients is most at risk
for nonketotic hyperglycemic
A. A 9-year-old boy with Type I diabetes,
D. following supersized milkshake and
A 37-year-old women who develops
A 76-year-old man with Type II diabetes
who has the flu.
An 82-year-old woman with Type II diabetes
who misses lunch.
who Type II Diabetes is best
A. a resistance to insulin by insulin-sensitive tissues.
B. the need for lispro instead of regular
C. an increase of glucagon secretion from a
cells of the pancreas.
D. the presence of insulin autoantibodies
that destroy ß cells in the pancreas. The first lab test that indicates Type I
Diabetes is causing the development of
diabetic nephropathy is:
A. Dipstick for urine ketones
B. Increase in serum creatinine
C. Protein on urinalysis
D. Cloudy urine on urinalysis...
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This document was uploaded on 03/25/2014.
- Spring '14