A male client with type 1 diabetes mellitus (DM) develops a gangrenous toe and is admitted for possible amputation. Which pathophysiological consequence of DM has contributed to this client's complication?
Chronic kidney disease.
Diabetic retinopathy.
Peripheral neuropathy.
Hypertension.
The Correct Answer is C
A. Chronic kidney disease:
Chronic kidney disease (CKD) is a complication of diabetes mellitus (DM), but it typically develops over time due to long-standing hyperglycemia and its effects on the kidneys. While CKD can lead to various complications such as electrolyte imbalances and cardiovascular disease, it is not directly associated with the development of gangrenous toes.
B. Diabetic retinopathy:
Diabetic retinopathy is a complication of diabetes that affects the eyes, specifically the retina. It results from damage to the blood vessels in the retina due to prolonged hyperglycemia. While diabetic retinopathy can lead to vision impairment and blindness if left untreated, it is not directly associated with the development of gangrenous toes.
C. Peripheral neuropathy:
Peripheral neuropathy is a common complication of diabetes that results from damage to the peripheral nerves due to prolonged hyperglycemia. It can lead to sensory, motor, and autonomic nerve dysfunction. Peripheral neuropathy contributes to the development of complications such as diabetic foot ulcers and Charcot arthropathy, which can ultimately lead to gangrene if not properly managed.
D. Hypertension:
Hypertension, or high blood pressure, is a common comorbidity in individuals with diabetes mellitus. While hypertension can exacerbate complications such as diabetic nephropathy and cardiovascular disease, it is not directly associated with the development of gangrenous toes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Hypothyroidism is characterized by deficient production of thyroid hormones by the thyroid gland, leading to a decrease in circulating levels of triiodothyronine (T3) and thyroxine (T4). As a compensatory mechanism, the pituitary gland releases increased amounts of thyroid stimulating hormone (TSH) in an attempt to stimulate thyroid hormone production.
A) Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH):
This pattern of laboratory findings is not consistent with hypothyroidism. Hypothyroidism is characterized by decreased levels of T3 and T4 due to impaired thyroid function, leading to increased TSH levels as a compensatory response. Therefore, this option is incorrect.
B) Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH):
While TSH levels are typically increased in hypothyroidism, T3 levels are usually decreased. Therefore, the combination of increased T3 and TSH is not indicative of hypothyroidism. This option is incorrect.
C) Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH):
Correct. In hypothyroidism, there is a decrease in both T3 and T4 levels due to impaired thyroid function. As a compensatory mechanism, the pituitary gland releases increased amounts of TSH to stimulate the thyroid gland. Therefore, this pattern of laboratory findings is consistent with hypothyroidism.
D) Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4):
Decreased levels of TSH, T3, and T4 are not indicative of hypothyroidism. Hypothyroidism is characterized by elevated TSH levels and decreased T3 and T4 levels. Therefore, this option is incorrect.
Correct Answer is C
Explanation
The ABG results indicate respiratory acidosis (pH 7.0, PaCO2 66 mmHg) with compensatory metabolic alkalosis (HCO3- 24 mEq/L). The low PaO2 (60 mmHg) suggests hypoxemia.
pH 7.0: The pH is below the normal range (7.35 to 7.45), indicating acidosis.
PaCO2 66 mmHg: The PaCO2 is elevated above the normal range (35 to 45 mmHg), indicating respiratory acidosis.
HCO3- 24 mEq/L: The bicarbonate level is within the normal range (21 to 28 mEq/L), indicating compensatory metabolic alkalosis.
PaO2 60 mmHg: The PaO2 is decreased below the normal range (80 to 100 mmHg), indicating hypoxemia.
These findings suggest that the client is experiencing respiratory failure, which is characterized by inadequate gas exchange resulting in hypoxemia and hypercapnia. In this case, the massive pulmonary embolus is causing ventilation-perfusion (V/Q) mismatch, leading to impaired gas exchange and respiratory compromise. Tachycardia, hypotension, and audible bilateral pulmonary crackles further support the diagnosis of respiratory failure in the context of a massive pulmonary embolus.
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