A nurse is providing care for a client with hypokalemia. Which condition should the nurse monitor for?

 

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.

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.