A patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient has a BG value of 987 mg/dL. Which is the priority focus while providing care?
Identifying age-related changes
Monitoring BG level
Establishing the presence of an illness
Improving hydration status
The Correct Answer is D
D. The priority focus in the acute management of hyperosmolar hyperglycemia is improving hydration status. Patients with HHS are severely dehydrated due to the osmotic diuresis caused by extremely high blood glucose levels. Rapid rehydration is critical to prevent shock, improve organ perfusion, and reduce blood glucose levels.
A. It's important to consider age-related changes in any patient but this is not the immediate priority in the acute management of hyperosmolar hyperglycemia. The primary concern is addressing the acute, life-threatening aspects of the condition.
B. Monitoring blood glucose levels is critical in managing hyperosmolar hyperglycemia. However, while it is essential to track the BG levels to guide insulin therapy and assess the response to treatment, it is not the immediate priority in terms of interventions needed to stabilize the patient initially.
C. Determining the underlying cause of hyperosmolar hyperglycemia, such as an infection or other illness, is important for comprehensive treatment. However, it is a secondary priority to stabilizing the patient’s current acute condition.
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Related Questions
Correct Answer is A
Explanation
A. Type 1 diabetes is an autoimmune condition where the body's immune system attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the pancreas produces little to no insulin, which is essential for regulating blood glucose levels.
B. Type 1 diabetes is not reversible. It is a lifelong condition that requires ongoing management with insulin therapy. While diet, exercise, and weight management are important for overall health and can help manage blood glucose levels, they cannot reverse type 1 diabetes.
C. This description is characteristic of type 2 diabetes, not type 1. In type 2 diabetes, the body’s cells become resistant to the effects of insulin, and the pancreas may not produce enough insulin. In type 1 diabetes, the problem is the lack of insulin production due to autoimmune destruction of the pancreatic beta cells.
D. Insulin is not released into the gastrointestinal tract. Insulin is a hormone that is released into the bloodstream by the pancreas. Its primary role is to help regulate blood glucose levels by facilitating the uptake of glucose into the body's cells for energy.
Correct Answer is B
Explanation
B. Severe upper abdominal pain is a hallmark symptom of gastrointestinal perforation. Perforation can lead to the leakage of gastric contents into the peritoneal cavity, causing intense, sharp pain in the upper abdomen. The pain may be sudden and severe and can radiate to the back or shoulders.
A. Bradycardia, or a slow heart rate, is not typically associated with gastrointestinal perforation. Instead, tachycardia (rapid heart rate) is more commonly observed due to the body's response to shock or inflammation caused by perforation.
C. Hyperactive bowel sounds are more commonly associated with conditions such as gastroenteritis or bowel obstruction. In the case of gastrointestinal perforation, bowel sounds may initially be normal but can eventually become absent due to peritoneal irritation and subsequent paralytic ileus.
D. Epigastric fullness may be present in peptic ulcer disease but is not a specific manifestation of gastrointestinal perforation. Perforation is more likely to present with severe, acute pain rather than a sensation of fullness.
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