A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client’s beta cells are restoring normal function?

Fasting blood glucose of 140 mg/dL.

Client reports smoking cessation.

Weight gain of 5 lb.

Answer and Explanation

The Correct Answer is A

Choice A: Fasting blood glucose of 140 mg/dL

A fasting blood glucose level of 140 mg/dL is above the normal range (70-99 mg/dL) but may indicate some improvement in beta cell function if it was previously higher. In type 2 diabetes, beta cells in the pancreas are responsible for producing insulin. When beta cells start to restore their function, they can produce more insulin, which helps lower blood glucose levels. However, a fasting blood glucose level of 140 mg/dL still indicates that the client has diabetes and needs to continue managing their condition.

Choice B: Client reports smoking cessation

Smoking cessation is a positive health behavior and can improve overall health, including cardiovascular health, which is often compromised in individuals with diabetes. However, it does not directly indicate the restoration of beta cell function. Beta cell function is specifically related to the pancreas’s ability to produce insulin, and smoking cessation, while beneficial, does not directly impact this.

Choice C: Weight gain of 5 lb

Weight gain can have various implications for a person with type 2 diabetes. While modest weight gain might indicate improved nutritional status or muscle mass, it does not directly indicate the restoration of beta cell function. In fact, weight gain can sometimes worsen insulin resistance, making it harder for beta cells to function effectively.

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Correct Answer is A

Explanation

The correct answer is a) Serum potassium levels.

Choice A reason:

Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.

Choice B reason:

Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.

Choice C reason:

Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.

Choice D reason:

Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.

A. Synchronized electrical cardioversion B. Heart catheterization with percutaneous intervention C. Cardiac resynchronization therapy (CRT) D. Echocardiogram

Correct Answer is C

Explanation

Choice A reason: Synchronized Electrical Cardioversion

Synchronized electrical cardioversion is a procedure that uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle to restore a normal heart rhythm. It is typically used to treat certain types of arrhythmias, such as atrial fibrillation, atrial flutter, and supraventricular tachycardia. However, it is not the primary treatment for heart failure with arrhythmias. This procedure is more suited for acute management of arrhythmias rather than long-term regulation of heart rhythm in heart failure patients.

Choice B reason: Heart Catheterization with Percutaneous Intervention

Heart catheterization with percutaneous intervention, also known as percutaneous coronary intervention (PCI), involves using a catheter to open up blocked coronary arteries. This procedure is primarily used to treat coronary artery disease and improve blood flow to the heart muscle. While it can alleviate symptoms of heart disease and prevent heart attacks, it does not directly address the issue of arrhythmias associated with heart failure. Therefore, it is not the most appropriate choice for regulating heart rhythm in this context.

Choice C reason: Cardiac Resynchronization Therapy (CRT)

Cardiac resynchronization therapy (CRT) is a specialized treatment for heart failure patients who have developed arrhythmias. CRT involves implanting a device called a biventricular pacemaker, which sends electrical signals to both the left and right ventricles to help them contract in a more synchronized manner. This improves the efficiency of the heart’s pumping action and can significantly alleviate symptoms of heart failure, such as shortness of breath and fatigue. CRT is particularly beneficial for patients with moderate to severe heart failure and those whose heart chambers do not beat in unison. This makes CRT the most appropriate choice for regulating heart rhythm in a patient with worsening heart failure and arrhythmias.

Choice D reason: Echocardiogram

An echocardiogram is a diagnostic test that uses ultrasound waves to create images of the heart. It provides detailed information about the heart’s structure and function, including the size and shape of the heart chambers, the movement of the heart walls, and the function of the heart valves. While an echocardiogram is essential for diagnosing and monitoring heart conditions, it is not a treatment procedure. It does not regulate heart rhythm but rather helps in assessing the severity of heart failure and guiding treatment decisions.

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A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client’s beta cells are restoring normal function?

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Explanation

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