A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?
Stomatitis and Diarrhea
Dyspnea and Anuria
Confusion and Vomiting
Nocturia and Oliguria
The Correct Answer is D
Choice A rationale: These are symptoms of advance renal failure. Stomatitis and diarrhea are signs of uremia, which is the accumulation of waste products in the blood.
Choice B rationale: Dyspnea and anuria are signs of fluid overload and kidney shutdown and indicate advanced renal failure.
Choice C rationale: Confusion and vomiting are signs of acidosis and electrolyte disturbances and occur in advanced stages of renal failure.
Choice D rationale: One of the early symptoms of renal insufficiency is nocturia, which is the need to urinate frequently at night. This occurs because the kidneys are unable to concentrate urine during the day and produce more urine at night. Another early symptom is oliguria, which is the production of less than 400 mL of urine per day. This occurs because the kidneys are unable to excrete enough urine to maintain fluid balance.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale: Symptoms and findings described align more with an acute, severe condition rather than a chronic one.
Choice B rationale: While cholecystitis can present with similar symptoms, the radiation of pain to the back is more indicative of a different condition.
Choice C rationale: Cholelithiasis (gallstones) might cause abdominal pain but typically doesn’t lead to fever and hypotension.
Choice D rationale: Symptoms including severe abdominal pain, radiation to the back, fever, and hypotension suggest acute pancreatitis, a potentially serious condition requiring urgent medical attention.
Correct Answer is A
Explanation
Choice A rationale: With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased. This means that the pancreas does not produce enough insulin, and the cells of the body do not respond well to the insulin that is available. Insulin is a hormone that helps the body use glucose (sugar) for energy. Without enough insulin or with insulin resistance, glucose builds up in the blood, leading to high blood sugar levels and various complications.
Choice B rationale: This statement describes Type 1 diabetes, where the immune system destroys insulin-producing cells.
Choice C rationale: This describes type 1 diabetes, not type 2 diabetes. People with type 2 diabetes may or may not need to take insulin, depending on how well they can control their blood sugar levels with diet, exercise, and oral medications.
Choice D rationale: This refers to pancreatitis, which is a condition where the pancreas becomes inflamed due to infection, injury, or alcohol abuse. Pancreatitis can cause
severe abdominal pain, nausea, vomiting, fever, and elevated levels of pancreatic enzymes in the blood.
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