Diabetes Mellitus Complications (HHNS and DKA) NCLEX Questions And Answers With Verified Solutions

A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessment of the patient, you suspect DKA rather than HHS based on the finding of A. polyuria. B. severe dehydration. C. rapid, deep respirations. D. decreased serum potassium. - C. rapid, deep respirations. Rapid, deep respirations are Kussmaul's and are are the body's attempt to reverse metabolic acidosis through exhalation of excess carbon dioxide. Symptoms of DKA include manifestations of dehydration, such as poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Kussmaul respirations (rapid, deep breathing associated with dyspnea) are the body's attempt to reverse metabolic acidosis through exhalation of excess carbon dioxide. Acetone is detected on the breath as a sweet, fruity odor. Laboratory results are available for a 54-year-old patient with a 15-year history of diabetes. Which result follows the expected pattern accompanying macrovascular disease as a complication of diabetes? A. Increased triglyceride levels B. Decreased low-density lipoprotein levels C. Increased high-density lipoprotein levels D. Decreased very-low-density lipoprotein levels - A. Increased triglyceride levels Macrovascular complications of diabetes include changes in medium- and large-sized blood vessels. They include cerebrovascular, cardiovascular, and peripheral vascular disease. Increased triglyceride levels are associated with these macrovascular changes. For this reason, the patient should limit the amount of fat in the diet. The elderly patient with type 2 diabetes mellitus presents to the clinic with a fever and productive cough. The diagnosis of pneumonia is made. You notice tenting skin, deep tongue furrows, and vital signs of 110/80 mm Hg, 120 beats/minute, and 24 breaths/minute. What assessment is important for you to obtain? A. Blood glucose B. Orthostatic blood pressuresC. Urine ketones D. Temperature - A. Blood glucose HHS is typically seen in patients with type 2 diabetes and infection, such as pneumonia. The main presenting sign is a glucose level above 600 mg/dL. Enough evidence of dehydration already exists that orthostatic vital sign assessments are not a priority, and they are often inaccurate in the elderly due to poor vascular tone. Patients with HHS do not have elevated ketone levels, which is a key distinction between HHS and DKA. Temperature will eventually be taken but is often blunted in the elderly and diabetics. An infectious diagnosis has already been made. The glucose level for appropriate fluid and insulin treatment is the priority. The male patient with diabetes and heart disease confides to you that he can no longer have an erection. What is the reason for these changes? A. It is a normal part of aging and is relieved with sildenafil (Viagra). B. It usually is related to emotions and is a temporary problem. C. It is often the first sign of diabetic autonomic neuropathy. D. It indicates that the patient has developed a neurogenic bladder. - C. It is often the first sign of diabetic autonomic neuropathy. Erectile dysfunction (ED) is common and often is the first manifestation of autonomic failure. ED is a common long-term complication of diabetes. Neurogenic bladder is related to urinary retention