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Exhibits

For each assessment finding, click to specify if the assessment finding is consistent with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). Each finding may support more than 1 disease process.

A.

Urine ketones

B.

Creatinine greater than expected reference range

C.

Blood glucose greater than expected reference range

D.

Skin turgor

E.

Blood pH greater than expected reference range

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

  • Urine ketones:

They are commonly present in DKA due to the breakdown of fats as an alternative energy source when insulin is insufficient. Ketones in urine are a hallmark sign of DKA.

Ketones may not be present in urine in HHS because insulin levels are sufficient to prevent excessive breakdown of fats. Therefore, urine ketones are more specific to DKA.

  • Creatinine greater than expected reference range

DKA: In DKA, dehydration and electrolyte imbalances can lead to acute kidney injury (AKI), resulting in elevated creatinine levels.

HHS: Elevated creatinine can also occur in HHS due to severe dehydration and reduced kidney perfusion.

  • Blood glucose greater than expected reference range:

DKA: Extremely high blood glucose levels (typically >250 mg/dL) are a hallmark of DKA due to insulin deficiency and the resultant inability to transport glucose into cells for energy.

HHS: Similar to DKA, HHS is characterized by extremely high blood glucose levels (often >600 mg/dL). Therefore, elevated blood glucose levels are consistent with both DKA and HHS.

  • Skin turgor

DKA: Decreased skin turgor is indicative of dehydration, which is common in DKA due to excessive urination (polyuria) and fluid loss.

HHS: Similarly, decreased skin turgor can also be seen in HHS due to profound dehydration caused by excessive hyperglycemia and osmotic diuresis.

  • Blood pH greater than expected reference range

DKA: DKA is characterized by metabolic acidosis, leading to a decreased blood pH (<7.35). Therefore, a pH greater than expected reference range would not be typical for DKA.

HHS: HHS, on the other hand, is characterized by severe hyperglycemia without significant ketoacidosis. Patients with HHS can have a normal or even elevated blood pH (>7.45) due to compensation mechanisms and absence of significant acidosis.


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Related Questions

Correct Answer is A

Explanation

A This statement indicates an understanding of the right to refuse treatment at any time, even after it has been initiated. Clients have the right to change their mind about treatment options and can withdraw their consent at any stage of treatment.

B. This statement suggests a misunderstanding of informed consent. Informed consent means the client understands the risks, benefits, and alternatives to a proposed treatment or procedure. Signing a consent form because one believes there are no other options does not reflect an informed decision- making process.

C. This statement indicates a misconception about treatment options. Clients have the right to refuse a specific treatment plan or procedure and explore other options or seek a second opinion. Refusal of one treatment does not necessarily preclude the possibility of pursuing alternative treatments.

D. This statement indicates a misunderstanding of the risks associated with treatment. It's crucial for clients to understand both the potential benefits and possible adverse effects of any treatment they undergo. Radiation treatment, like any medical intervention, carries risks that should be weighed against potential benefits.

Correct Answer is C

Explanation

C. Heat therapy can help relax muscles and relieve stiffness in the joints, making it easier to move around and start the day.

A While it's important to maintain a regular sleep schedule, short naps may actually help manage fatigue associated with the condition

B. Cold therapy, such as using ice packs, can actually help reduce inflammation and relieve pain in inflamed joints for many individuals with RA.

D. Decreasing the amount of iron in the diet is not advisable without specific medical guidance.

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