A nurse is providing education to a client who has hypoglycemia. Which of the following information should the nurse include about the regulation of blood glucose levels?

The adrenal glands release epinephrine and norepinephrine to respond to low blood glucose.

The liver releases glucagon to regulate blood glucose levels.

Glycogenesis occurs in the pancreas when blood glucose levels fall.

The brain uses protein for energy if glucose levels fall too low.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

The adrenal glands play a crucial role in responding to low blood glucose levels by releasing epinephrine (adrenaline) and norepinephrine. These hormones help to increase blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen to glucose) and gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver. This response is part of the body’s fight-or-flight mechanism, which ensures that sufficient glucose is available for immediate energy needs.

Choice B Reason:

The liver does not release glucagon; rather, it responds to glucagon, which is released by the pancreas. Glucagon stimulates the liver to convert stored glycogen into glucose (glycogenolysis) and to produce glucose from non-carbohydrate sources (gluconeogenesis). This process helps to raise blood glucose levels when they are low.

Choice C Reason:

Glycogenesis is the process of converting glucose into glycogen for storage, and it occurs primarily in the liver and muscle cells, not in the pancreas. The pancreas releases insulin to promote glycogenesis when blood glucose levels are high, but it does not perform glycogenesis itself.

Choice D Reason:

The brain primarily uses glucose for energy and does not switch to using protein unless glucose levels are extremely low and prolonged. In such cases, the brain can use ketone bodies derived from fat as an alternative energy source. Protein is not a primary energy source for the brain under normal conditions.

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Correct Answer is B

Explanation

Choice A reason: Increased Serum Sodium

Increased serum sodium, or hypernatremia, is not consistent with SIADH. SIADH typically results in hyponatremia, which is a low level of sodium in the blood due to excessive water retention. The excess antidiuretic hormone (ADH) causes the kidneys to retain water, diluting the sodium in the bloodstream. Therefore, increased serum sodium is not a characteristic finding in SIADH.

Choice B reason: Decreased Serum Osmolality

Decreased serum osmolality is a hallmark of SIADH3. Serum osmolality measures the concentration of solutes in the blood. In SIADH, the excessive release of ADH leads to water retention, diluting the blood and lowering serum osmolality. This is a key diagnostic feature of SIADH and helps differentiate it from other conditions.

Choice C reason: Decreased Urinary Sodium

Decreased urinary sodium is not typically seen in SIADH. In fact, patients with SIADH usually have increased urinary sodium levels. This is because the kidneys excrete more sodium in an attempt to balance the excess water retained due to high ADH levels. Therefore, decreased urinary sodium is not consistent with SIADH.

Choice D reason: Decreased Urine Osmolality

Decreased urine osmolality is also not consistent with SIADH. In SIADH, urine osmolality is typically increased because the kidneys concentrate the urine due to the action of ADH. The high levels of ADH cause the kidneys to reabsorb water, resulting in more concentrated urine. Thus, decreased urine osmolality is not a characteristic finding in SIADH.

A. The client who had a myocardial infarction and required stent placement. B. The client whose mother and uncle were diagnosed with this same condition. C. The client who is recovering from a recent illness that caused vomiting and diarrhea. D. The client who is out of work and has been experiencing increased stress.

Correct Answer is A

Explanation

Choice A Reason:

A history of myocardial infarction (heart attack) and the need for stent placement are significant risk factors for developing atrial flutter. Atrial flutter is often associated with structural heart disease, including coronary artery disease, which can lead to myocardial infarction. The damage to the heart muscle and the changes in the heart’s electrical system following a myocardial infarction can predispose a person to atrial flutter.

Choice B Reason:

While a family history of atrial flutter can indicate a genetic predisposition to arrhythmias, it is not as strong a risk factor as having a history of myocardial infarction and stent placement. Genetic factors can play a role, but they are typically less influential compared to direct cardiac events.

Choice C Reason:

Recovering from an illness that caused vomiting and diarrhea is not a direct risk factor for atrial flutter. These conditions can lead to electrolyte imbalances, which might temporarily affect heart rhythm, but they do not typically cause atrial flutter.

Choice D Reason:

Increased stress can contribute to various health issues, including heart problems, but it is not a primary risk factor for atrial flutter. Chronic stress can exacerbate existing heart conditions, but it is not as significant a risk factor as a history of myocardial infarction.

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A nurse is providing education to a client who has hypoglycemia. Which of the following information should the nurse include about the regulation of blood glucose levels?

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Correct Answer is B

Explanation

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Correct Answer is A

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