A 26-year-old patient is admitted to the hospital with a new diagnosis of diabetes, a blood glucose level of 680 mg/dL and ketones in the blood and urine. Which type of diabetes should the nurse suspect?
Gestational
Prediabetes
Type 1
Type 2
The Correct Answer is C
A. Gestational: Gestational diabetes occurs during pregnancy and does not involve ketones in blood and urine, which are indicative of diabetic ketoacidosis (DKA).
B. Prediabetes: Prediabetes involves mildly elevated glucose levels but does not present with ketones or DKA.
C. Type 1: Type 1 diabetes is characterized by an absolute insulin deficiency, leading to hyperglycemia and ketone production. DKA is a hallmark presentation of untreated or newly diagnosed Type 1 diabetes.
D. Type 2: Type 2 diabetes is less likely to present with DKA as insulin production is typically sufficient to prevent significant ketone formation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Check the client for hypoglycemia 4 hr after the insulin lispro injection: Insulin lispro is rapid-acting, with a peak effect 1-2 hours after administration. Monitoring for hypoglycemia should focus on this timeframe, not 4 hours later.
B. Inject insulin lispro 15 min before a meal: Insulin lispro has an onset of action of about 15 minutes, making it ideal to administer shortly before meals to match glucose absorption and prevent postprandial hyperglycemia.
C. Administer insulin lispro in the same syringe as a short-acting insulin: Mixing insulin lispro with other insulins is not recommended; each type has specific mixing guidelines, and lispro is typically given alone.
D. Monitor the client for polyuria after the insulin lispro injection: Polyuria is a symptom of hyperglycemia, not an expected finding after insulin administration. Insulin lispro should reduce hyperglycemia and associated symptoms.
Correct Answer is A
Explanation
A. Insulin injections daily: Uncontrolled blood glucose levels, despite dietary compliance, indicate that the pancreas may not be producing adequate insulin. Daily insulin is necessary to control hyperglycemia in this situation.
B. Fluid restrictions: Fluid restrictions are not indicated unless the client has comorbidities like heart or renal failure.
C. Oral hypoglycemic medications: Oral medications are often ineffective for Type 1 diabetes or severe cases of Type 2 diabetes with marked hyperglycemia.
D. Peritoneal dialysis therapy: This is a treatment for end-stage renal disease, not uncontrolled diabetes mellitus.
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