The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)

an upper urinary tract infection

decreased caloric intake

aerobic exercise

clogged tubing of a subcutaneous insulin pump

not taking sufficient insulin

Answer and Explanation

Correct Answer : A,B,D,E

A.   Infections, including urinary tract infections, can increase insulin resistance and elevate blood glucose levels, potentially leading to DKA. The stress response from infection can also increase cortisol levels, further contributing to hyperglycemia.
B.   Decreased caloric intake can lead to inadequate insulin levels relative to the body’s needs. In Type 1 diabetes, if insulin is not sufficient to metabolize glucose (due to low intake or other reasons), the body may resort to fat metabolism, leading to the production of ketones and the development of DKA.
C.   While exercise can affect blood glucose levels, it typically lowers them and is not a direct cause of DKA. In fact, moderate aerobic exercise is usually encouraged for managing diabetes. However, if blood glucose levels are already high before exercise, it may exacerbate the situation, but aerobic exercise itself is not a cause of DKA.
D.   Clogged tubing can prevent insulin delivery, leading to insufficient insulin levels. This lack of insulin can result in elevated blood glucose levels and, ultimately, the risk of DKA if not addressed.
E.   Not taking enough insulin is a primary cause of DKA in Type 1 diabetes. Without adequate insulin, the body cannot utilize glucose properly, leading to increased fat metabolism and the production of ketones, which can cause DKA.

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Correct Answer is B

Explanation

A. Heparin does not actually "thin" the blood in the sense of reducing viscosity. Instead, it works by inhibiting certain factors in the coagulation cascade, preventing clot formation. Thus, this response does not accurately describe how heparin functions.

B. Heparin works by activating antithrombin III, which inhibits thrombin and factor Xa, thereby preventing the formation of new clots. It does not dissolve existing clots but helps to prevent the enlargement of existing ones and the formation of new clots.
C. Heparin does not decrease the number of platelets; rather, it interferes with the clotting process by inhibiting specific clotting factors. Platelets may still be present, but their ability to form clots is inhibited by the action of heparin.
D. Heparin does not dissolve existing clots; that function is typically performed by thrombolytic agents. Heparin primarily prevents new clot formation and the extension of existing clots. Additionally, it does not decrease platelet formation.

A. would need so much of an oral antihypoglycemic agent that it would cost too much. B. are allergic to oral antihypoglycemic agents. C. would have more episodes of hypoglycemia with oral antihypoglycemic agents. D. have little or none of their own insulin that can be released.

Correct Answer is B

Explanation

A. The effectiveness of oral antihypoglycemic agents does not depend on dosage amounts that would make them cost-prohibitive. Instead, these medications work by stimulating insulin production or enhancing insulin sensitivity, which is not relevant for Type 1 diabetes.
B. While some individuals may have allergies to certain medications, this is not the reason oral antihypoglycemic agents are ineffective for those with Type 1 diabetes. The ineffectiveness is not related to allergy but rather to the underlying pathology of the disease.
C. While it is true that the risk of hypoglycemia exists with all glucose-lowering therapies, this is not the primary reason why oral antihypoglycemics are ineffective in Type 1 diabetes. The use of these agents may increase hypoglycemia risk in a broader context, but the fundamental issue is related to insulin deficiency.
D. In Type 1 diabetes, the pancreas produces little to no insulin due to autoimmune destruction of insulin-producing beta cells. Oral antihypoglycemic agents typically rely on the presence of some endogenous insulin to be effective.

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The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)

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