For the patient with diabetes mellitus, which microvascular complication of the blood vessel structure may occur? Select all that apply. One, some, or all responses may be correct.

Nephropathy

Neuropathy

Peripheral vascular disease

Cerebral vascular disease

Retinopathy

Answer and Explanation

Correct Answer : A,B,E

Choice A: Nephropathy

Diabetic nephropathy is a common microvascular complication of diabetes mellitus. It is characterized by damage to the small blood vessels in the kidneys, leading to progressive kidney disease. The condition is often identified by the presence of protein in the urine (proteinuria) and can progress to end-stage renal disease if not managed properly. The primary mechanism involves hyperglycemia-induced damage to the glomeruli, the filtering units of the kidneys. This damage results in increased permeability and eventual scarring, impairing kidney function. Effective management of blood glucose levels and blood pressure is crucial in preventing or slowing the progression of diabetic nephropathy.

Choice B: Neuropathy

Diabetic neuropathy refers to nerve damage caused by chronic high blood sugar levels. It is another significant microvascular complication of diabetes. This condition can affect various types of nerves, including sensory, motor, and autonomic nerves. Symptoms may include pain, tingling, numbness, and loss of sensation, particularly in the extremities. Diabetic neuropathy can lead to severe complications such as foot ulcers and infections, which may necessitate amputation. The pathophysiology involves hyperglycemia-induced oxidative stress and inflammation, leading to nerve damage. Tight glycemic control and regular monitoring are essential in managing diabetic neuropathy.

Choice E: Retinopathy

Diabetic retinopathy is a leading cause of blindness among adults with diabetes. This microvascular complication involves damage to the small blood vessels in the retina, the light-sensitive tissue at the back of the eye. There are two main types: non-proliferative and proliferative retinopathy. Non-proliferative retinopathy is characterized by microaneurysms, hemorrhages, and exudates, while proliferative retinopathy involves the growth of new, fragile blood vessels that can bleed and cause retinal detachment. The primary cause is prolonged hyperglycemia, which damages the retinal blood vessels. Regular eye examinations and good glycemic control are vital in preventing and managing diabetic retinopathy.

Choice C: Peripheral Vascular Disease

Peripheral vascular disease (PVD) is not classified as a microvascular complication but rather a macrovascular one. It involves the narrowing or blockage of the blood vessels outside the heart and brain, primarily affecting the arteries in the legs. PVD is associated with atherosclerosis, where plaque builds up in the arterial walls, leading to reduced blood flow. Symptoms include leg pain, cramping, and ulcers. While PVD is a significant concern for individuals with diabetes, it is not considered a microvascular complication.

Choice D: Cerebral Vascular Disease

Cerebral vascular disease, which includes conditions such as stroke and transient ischemic attacks (TIAs), is also a macrovascular complication rather than a microvascular one. It involves the blood vessels supplying the brain and is primarily caused by atherosclerosis and hypertension. Diabetes increases the risk of cerebral vascular disease due to its association with other risk factors like high blood pressure and dyslipidemia. However, it is not classified as a microvascular complication.

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Correct Answer is ["C","D","E"]

Explanation

Choice A reason: Stretch marks, also known as striae, are not specific to ascites. They can occur due to rapid weight gain or loss, pregnancy, or other conditions that cause the skin to stretch. While they may be present in individuals with ascites due to rapid abdominal expansion, they are not a primary clinical manifestation of ascites.

Choice B reason: Foul-smelling breath, or halitosis, is not a typical symptom of ascites. It can be associated with various conditions, including poor oral hygiene, gastrointestinal disorders, or liver disease, but it is not a direct indicator of ascites.

Choice C reason: Increased abdominal girth is a primary clinical manifestation of ascites. Ascites is characterized by the accumulation of fluid in the peritoneal cavity, leading to noticeable abdominal distension. This symptom is often accompanied by a feeling of fullness or bloating.

Choice D reason: Visible distended veins, particularly around the abdomen, can be a sign of ascites. This occurs due to increased pressure in the abdominal veins as a result of fluid accumulation. The veins become more prominent and visible under the skin.

Choice E reason: Rapid weight gain is another key indicator of ascites. The accumulation of fluid in the abdomen leads to a significant increase in body weight over a short period. This rapid weight gain is often one of the first signs that prompts further investigation for ascites.

A. Formed stool in collection pouch. B. Stoma is edematous and bleeding. C. Stoma is pink and shiny. D. Skin excoriation around the stoma. E. Mucus liquid flows from the stoma.

Correct Answer is ["C","E"]

Explanation

Choice A: Formed stool in collection pouch

Formed stool in the collection pouch is not expected in an ileostomy. The output from an ileostomy is typically liquid to semi-liquid because the ileum does not absorb as much water as the colon. If formed stool is present, it may indicate a blockage or other issue that needs to be addressed.

Choice B: Stoma is edematous and bleeding

An edematous and bleeding stoma is not a normal finding and may indicate complications such as infection, trauma, or poor stoma care. The stoma should be moist and pink, but not swollen or bleeding. Persistent bleeding or significant edema should be reported to a healthcare provider immediately.

Choice C: Stoma is pink and shiny

A pink and shiny stoma is a sign that the ileostomy is functioning well. This indicates good blood flow and healthy tissue. The stoma should always appear moist and pink, similar to the inside of the mouth. Any deviation from this appearance, such as a pale, dark, or dry stoma, should be evaluated by a healthcare professional.

Choice D: Skin excoriation around the stoma

Skin excoriation around the stoma is not a normal finding and suggests that the skin is being irritated by the stoma output or the ostomy appliance. Proper skin care and fitting of the ostomy appliance are essential to prevent skin breakdown. If excoriation occurs, it should be treated promptly to prevent further complications.

Choice E: Mucus liquid flows from the stoma

Mucus liquid flowing from the stoma is expected in an ileostomy. The output is typically liquid to semi-liquid and may contain mucus, which is normal for the small intestine. This type of output indicates that the ileostomy is functioning as intended.

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For the patient with diabetes mellitus, which microvascular complication of the blood vessel structure may occur? Select all that apply. One, some, or all responses may be correct.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["C","D","E"]

Explanation

The nurse is caring for a client with an ileostomy because of inflammatory bowel disease. Which assessment findings indicate to the nurse that the ileostomy is functioning as expected? Select all that apply.

Correct Answer is ["C","E"]

Explanation

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