Aron comes into the clinic after 6 months for a follow-up visit. He indicates that his blood sugars have been around 100 to 120 mg/dL, and he has been fully participating in the other aspects of his diabetes management plan. Which would lead you to believe that he has not been in tight control of his diabetes?
A reduced glycosylated hemoglobin level (Hemoglobin A1C).
An elevated glycosylated hemoglobin level.
A random blood sugar of 150 mg/dL performed in the clinic.
There is no method to determine whether the patient is in tight glucose control.
The Correct Answer is B
Choice A reason: A reduced glycosylated hemoglobin level (Hemoglobin A1C) indicates that blood sugar levels have been well-controlled over the past three months. Hemoglobin A1C is a measure of the average blood glucose levels over this period. A lower A1C level suggests that the patient has been maintaining good control of their blood sugar levels, making it an unlikely indicator of poor diabetes management. The normal range for Hemoglobin A1C is below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes, and levels above 6.5% indicate diabetes.
Choice B reason: An elevated glycosylated hemoglobin level is a clear indicator that the patient has not been maintaining tight control of their blood sugar levels. Hemoglobin A1C reflects the average blood glucose levels over the past three months. If the A1C level is high, it suggests that the patient's blood sugar levels have been elevated consistently over this period. This can occur despite the patient reporting blood sugar levels within the target range during clinic visits. An elevated A1C level (greater than 6.5%) is a strong sign of inadequate diabetes management and suggests the need for adjustments in the treatment plan.
Choice C reason: A random blood sugar level of 150 mg/dL performed in the clinic provides a snapshot of the patient's blood sugar level at a single point in time. While this level is above the normal range (typically below 140 mg/dL for non-diabetics), it does not provide a comprehensive picture of the patient's overall blood sugar control. Blood sugar levels can fluctuate due to various factors, including recent meals, stress, and physical activity. Therefore, a single random blood sugar reading is not a reliable indicator of tight diabetes control.
Choice D reason: The statement that there is no method to determine whether the patient is in tight glucose control is incorrect. There are several methods to assess diabetes control, with the Hemoglobin A1C test being one of the most reliable. Additionally, frequent monitoring of blood sugar levels through self-testing and continuous glucose monitoring systems can provide valuable information about how well the patient is managing their diabetes. These methods allow healthcare providers to make informed decisions about treatment adjustments and overall diabetes management strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The overall goal of treatment for both type 1 and type 2 diabetes is to maintain blood glucose levels within a normal range and prevent complications. While the strategies to achieve these goals may differ, the ultimate objectives are similar for both types of diabetes.
Choice B reason: The treatment for type 1 diabetes primarily involves insulin therapy, as the body cannot produce insulin. In contrast, type 2 diabetes treatment often starts with lifestyle changes and oral medications to improve insulin sensitivity and control blood glucose levels. Insulin therapy may be required later in the course of type 2 diabetes if other treatments are insufficient.
Choice C reason: Both types of diabetes are diagnosed using similar criteria, including measuring blood glucose levels through fasting blood glucose tests, oral glucose tolerance tests, and HbA1c levels. The diagnosis process itself is not a major differentiating factor between the two types.
Choice D reason: The potential long-term complications of both type 1 and type 2 diabetes are similar and include cardiovascular disease, neuropathy, nephropathy, retinopathy, and other complications related to prolonged high blood glucose levels. While the risk factors and progression may vary, the types of complications are not significantly different between the two conditions.
Correct Answer is C
Explanation
Choice A reason: NGT (nasogastric tube) is used for enteral feeding, not parenteral nutrition. Enteral feeding involves delivering nutrients directly to the stomach or small intestine, bypassing the need for eating. This method is suitable for patients who have a functioning digestive system but cannot eat orally. Parenteral nutrition, on the other hand, involves delivering nutrients directly into the bloodstream.
Choice B reason: Oral administration of nutrition involves consuming food or nutrients by mouth. This method is suitable for individuals who can eat and digest food normally. Parenteral nutrition bypasses the digestive system altogether and delivers nutrients directly into the bloodstream, making oral administration inappropriate for TPN.
Choice C reason: Central Line is the correct answer because Total Parenteral Nutrition (TPN) requires delivery of nutrients directly into a central vein, typically the superior vena cava. This is because TPN solutions are highly concentrated and can irritate smaller veins, leading to complications such as phlebitis. A central line allows for the safe administration of TPN, ensuring that the high osmolarity solution is rapidly diluted by the large volume of blood in the central veins.
Choice D reason: Peripheral line administration is used for Peripheral Parenteral Nutrition (PPN), not TPN. PPN can be delivered through a peripheral vein because it is less concentrated than TPN. Using a peripheral line for TPN is not appropriate due to the risk of complications from the high osmolarity of the TPN solution.
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