Diabetes Mellitus Overview Quiz
48 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a common symptom of hyperglycemia due to its osmotic effect?

  • Increased appetite
  • Joint pain
  • Blurred vision (correct)
  • Fatigue

Which of the following conditions are associated with hyperglycemia?

  • Hypoglycemia
  • Insulinoma
  • Polydipsia (correct)
  • Lactose intolerance

What is the diagnostic fasting plasma glucose level indicating possible diabetes?

  • 200 mg/dL
  • 126 mg/dL (correct)
  • 100 mg/dL
  • 150 mg/dL

Which of the following is NOT a typical manifestation of Type 2 Diabetes Mellitus?

<p>Weight loss (D)</p> Signup and view all the answers

Which factor is associated with an increased risk of developing Type 2 Diabetes Mellitus?

<p>Obesity (C)</p> Signup and view all the answers

What defines Type 2 Diabetes Mellitus?

<p>Fasting hyperglycemia with available insulin (C)</p> Signup and view all the answers

At what plasma glucose level is glycolysis impaired in the kidneys leading to glycosuria?

<p>180 mg/dL (A)</p> Signup and view all the answers

In patients with Type 2 Diabetes Mellitus, which factor can increase cellular resistance to insulin?

<p>Low physical activity (D)</p> Signup and view all the answers

What is a primary consequence of excessive ketone production in DKA?

<p>Metabolic acidosis (B)</p> Signup and view all the answers

Which factor is NOT a known cause of DKA?

<p>Increased physical activity (D)</p> Signup and view all the answers

During an illness, how should insulin dosing typically be adjusted?

<p>It should remain the same or possibly increase. (C)</p> Signup and view all the answers

What physiological response accompanies stressful events that may lead to DKA?

<p>Increased levels of stress hormones (B)</p> Signup and view all the answers

What is a potential error that might lead to a missed dose of insulin?

<p>Misunderstanding dosage instructions (C)</p> Signup and view all the answers

Which type of medication is known to potentially contribute to DKA?

<p>Corticosteroids (A)</p> Signup and view all the answers

What psychological factor may lead an adolescent with diabetes to skip insulin doses?

<p>Difficulty coping with diabetes (A)</p> Signup and view all the answers

Which of the following describes a consequence of not properly administering insulin?

<p>Increased risk of DKA (A)</p> Signup and view all the answers

What is a primary consequence of insulin deficiency in diabetic ketoacidosis (DKA)?

<p>Increased glucose production by the liver (B)</p> Signup and view all the answers

Which of the following is NOT one of the three main clinical features of DKA?

<p>Hypoglycemia (B)</p> Signup and view all the answers

In patients with severe DKA, what is the potential volume of water loss over a 24-hour period?

<p>6.5 liters (B)</p> Signup and view all the answers

What physiological disturbance occurs due to the accumulation of ketoacids in DKA?

<p>Metabolic acidosis (A)</p> Signup and view all the answers

What effect does osmotic diuresis have on electrolyte levels in DKA?

<p>Decreased levels of sodium and potassium (A)</p> Signup and view all the answers

Which of the following describes the relationship between glucose levels and insulin deficiency in DKA?

<p>Insulin deficiency causes elevated glucose levels (B)</p> Signup and view all the answers

What metabolic process is accelerated due to insulin deficiency in DKA?

<p>Lipolysis (B)</p> Signup and view all the answers

Which type of diabetes can experience diabetic ketoacidosis (DKA)?

<p>Both Type I and Type II Diabetes (B)</p> Signup and view all the answers

What is one of the consequences of not increasing insulin levels during illness or infection?

<p>Hyperglycemia may progress to DKA. (D)</p> Signup and view all the answers

Which of the following is NOT a common symptom of diabetic ketoacidosis (DKA)?

<p>Severe headaches (C)</p> Signup and view all the answers

What is measured in blood tests for diagnosing diabetic ketoacidosis?

<p>Blood sugar level, ketone level, and blood acidity (D)</p> Signup and view all the answers

What primarily differentiates Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) from DKA?

<p>Presence of hyperglycemia and hyperosmolarity (B)</p> Signup and view all the answers

Which symptom of diabetic ketoacidosis is often noted in home tests?

<p>High blood sugar level (B)</p> Signup and view all the answers

What can result from a high level of ketones in the bloodstream?

<p>Blood becoming acidic (D)</p> Signup and view all the answers

In diabetic ketoacidosis, why does blood sugar continue to rise?

<p>There is insufficient insulin to allow sugar entry into cells. (B)</p> Signup and view all the answers

What body response occurs when fat and protein are broken down for energy?

<p>Production of ketones (A)</p> Signup and view all the answers

What is the primary metabolic complication of diabetes mellitus characterized by elevated plasma osmolality and impaired mental status?

<p>Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) (D)</p> Signup and view all the answers

Which type of diabetes is predominantly associated with Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

<p>Type II Diabetes (C)</p> Signup and view all the answers

Which hormone's actions are counter-regulatory and contribute to the hyperglycemic state in HHNS?

<p>Cortisol (B)</p> Signup and view all the answers

What leads to the development of lactic acidosis in patients with HHNS?

<p>Poor tissue perfusion (D)</p> Signup and view all the answers

What dangerous cycle is triggered by Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

<p>Hyperglycemia, hyperosmolality, osmotic diuresis, and dehydration (A)</p> Signup and view all the answers

What condition is often a precursor to the development of HHNS due to impaired glucose excretion?

<p>Renal insufficiency (D)</p> Signup and view all the answers

Which of the following medical conditions can trigger Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

<p>Stroke (D)</p> Signup and view all the answers

What is the consequence of hemoconcentration in HHNS patients?

<p>Risk of clot formation (C)</p> Signup and view all the answers

What is a primary cause of hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

<p>Severe dehydration due to glucose levels above 600 mg/dl (A)</p> Signup and view all the answers

Which group of individuals is particularly at high risk for HHNS?

<p>Elderly patients with impaired cognition (C)</p> Signup and view all the answers

Which medication is known to adversely affect carbohydrate metabolism and could lead to glucose impairment?

<p>Corticosteroids (D)</p> Signup and view all the answers

What is a common symptom of hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

<p>Frequent urination leading to dehydration (B)</p> Signup and view all the answers

Which of the following factors can precipitate HHNS?

<p>Medication non-adherence (C)</p> Signup and view all the answers

What physiological change occurs in the body as a response to elevated glucose levels in HHNS?

<p>Thicker blood leading to dehydration (A)</p> Signup and view all the answers

What potential consequence may arise from untreated HHNS?

<p>Seizure or coma (B)</p> Signup and view all the answers

Which condition is NOT typically associated with the development of HHNS?

<p>Diabetes management adherence (A)</p> Signup and view all the answers

Flashcards

Hyperglycemia

High blood sugar level. This is a key feature of Diabetes Mellitus and can lead to several symptoms.

Polyuria

Increased urination. Hyperglycemia acts as an osmotic diuretic, drawing water out of the body with the excess glucose.

Glycosuria

Excess glucose in the urine. The kidneys can only filter a certain amount of glucose before it spills into the urine.

Polydipsia

Excessive thirst. Dehydration from polyuria triggers the body's thirst mechanism.

Signup and view all the flashcards

Polyphagia

Increased hunger. Cells cannot utilize glucose properly, so the body sends signals to eat more to obtain energy.

Signup and view all the flashcards

Diabetes Mellitus type 1

Diabetes Mellitus type 1 is an autoimmune disease where the body's own immune system attacks and destroys insulin-producing cells in the pancreas.

Signup and view all the flashcards

Diabetes Mellitus type 2

Diabetes Mellitus type 2 is a condition where cells become resistant to insulin, causing high blood sugar despite insulin production.

Signup and view all the flashcards

Risk factors for type 2 Diabetes

A group of risk factors that increase the likelihood of developing type 2 diabetes.

Signup and view all the flashcards

What is Diabetic Ketoacidosis (DKA)?

A condition where the body produces excessive amounts of ketones due to a lack of insulin. This leads to metabolic acidosis.

Signup and view all the flashcards

What is a major trigger for DKA?

Insufficient insulin production or administration can trigger DKA.

Signup and view all the flashcards

How can illness or infection contribute to DKA?

Illness or infection can increase insulin resistance and trigger DKA.

Signup and view all the flashcards

Can DKA be the first sign of diabetes?

Undiagnosed and untreated diabetes can manifest as DKA.

Signup and view all the flashcards

What medications can trigger DKA?

Certain medications, such as diuretics and corticosteroids, can increase glucose levels and trigger DKA.

Signup and view all the flashcards

How does stress contribute to DKA?

Stressful events can increase levels of stress hormones, leading to DKA.

Signup and view all the flashcards

How does illness affect insulin needs in diabetics?

Patients with diabetes who are ill may require increased insulin doses due to increased blood glucose levels.

Signup and view all the flashcards

What are some potential causes of insulin insufficiency?

Errors in insulin dosage and administration can lead to DKA.

Signup and view all the flashcards

Why does DKA happen?

DKA occurs when the body cannot use glucose for energy due to a lack of insulin. This forces the breakdown of fat, leading to the production of acidic ketone bodies.

Signup and view all the flashcards

What are the main features of DKA?

High blood sugar levels, dehydration due to water loss, and increased acidity in the body.

Signup and view all the flashcards

Who can experience DKA?

It can affect both people with Type 1 Diabetes and Type 2 Diabetes.

Signup and view all the flashcards

How does dehydration occur in DKA?

Excessive glucose in the blood leads to increased urine production, pulling water and important electrolytes out of the body.

Signup and view all the flashcards

What causes the acidic environment in DKA?

Ketones build up in the blood, making it acidic.

Signup and view all the flashcards

What is osmotic diuresis?

Osmotic diuresis, where excess glucose pulls water out through urination, leading to dehydration and electrolyte loss.

Signup and view all the flashcards

How does hyperglycemia contribute to DKA?

The liver produces more glucose, and cells cannot efficiently take up glucose due to insufficient insulin, resulting in high blood sugar.

Signup and view all the flashcards

Counter-regulatory hormones

Hormones that promote glucose production by the liver and reduce glucose utilization by muscle and fat tissue, counteracting the effect of insulin.

Signup and view all the flashcards

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

A serious condition in which high blood sugar and dehydration are predominant, with minimal or absent ketone production.

Signup and view all the flashcards

Diabetic Ketoacidosis (DKA)

A condition where the body produces ketones due to insufficient insulin, leading to high blood sugar levels.

Signup and view all the flashcards

Ketone production

When the body breaks down fat for energy, acidic compounds called ketones enter the bloodstream.

Signup and view all the flashcards

Blood Acidity

A high ketone level will cause the blood to become acidic which can disrupt organ function.

Signup and view all the flashcards

Ketones in Urine

Ketones are present in higher amounts in the urine during DKA.

Signup and view all the flashcards

Ketone level test

Blood tests used to measure the levels of ketones in the bloodstream.

Signup and view all the flashcards

What is Hyperosmolar Hyperglycemic State (HHNS)?

A condition where blood sugar levels rise extremely high (above 600 mg/dL), leading to severe dehydration.

Signup and view all the flashcards

How does insulin deficiency contribute to HHNS?

Insulin is a hormone that helps glucose enter cells for energy. Without enough insulin, glucose builds up in the blood, leading to HHNS.

Signup and view all the flashcards

Why does HHNS cause dehydration?

High blood sugar acts as a magnet for water, pulling it out of the body with the excess glucose.

Signup and view all the flashcards

What are the main triggers for HHNS?

Infections, poor blood sugar management, certain medications like glucocorticoids and diuretics, trauma, and preexisting conditions like heart failure or kidney disease.

Signup and view all the flashcards

How do HHNS symptoms present?

HHNS symptoms develop slowly, taking days or even weeks to appear.

Signup and view all the flashcards

What are some common symptoms of HHNS?

Frequent urination due to dehydration, excessive thirst, blurred vision, fatigue, confusion, and even seizures or coma.

Signup and view all the flashcards

Is HHNS a medical emergency?

HHNS is a serious medical condition that requires immediate medical attention. Prompt treatment with fluids and insulin is crucial.

Signup and view all the flashcards

Who is particularly vulnerable to HHNS?

Elderly individuals are at higher risk, especially those with cognitive impairment or residing in long-term care facilities.

Signup and view all the flashcards

Why does HHNS not involve ketoacidosis?

In HHNS, the body does not produce ketones like in DKA due to the presence of some circulating insulin, although insufficient for proper glucose utilization. The condition is triggered by a combination of insufficient insulin, counter-regulatory hormones (like cortisol and epinephrine), and impaired renal glucose excretion, leading to hyperglycemia and hyperosmolarity.

Signup and view all the flashcards

What is the difference between HHNS and Diabetic Ketoacidosis (DKA) in terms of ketone presence?

The absence of ketones in HHNS is attributed to the presence of some circulating insulin, although insufficient for proper glucose utilization. This contrasts with DKA, where the lack of insulin leads to ketone production.

Signup and view all the flashcards

How does impaired renal function contribute to HHNS?

HHNS often develops in individuals with impaired renal function or pre-existing kidney issues. This compromised kidney function hinders the body's ability to excrete excess glucose, leading to hyperglycemia and contributing to the development of HHNS.

Signup and view all the flashcards

What medical conditions can trigger HHNS?

HHNS can be triggered by severe medical conditions like stroke, heart attack, pancreatitis, trauma, infection, burns, or pneumonia. These conditions can lead to increased insulin resistance and hinder the body's ability to utilize glucose, contributing to the development of HHNS.

Signup and view all the flashcards

How does dehydration contribute to HHNS progression?

The dehydration that occurs in HHNS worsens as the body attempts to eliminate the excessive glucose, leading to increased serum glucose and osmolality. This dehydration further disrupts electrolyte balance and contributes to the development of CNS dysfunction, such as confusion and lethargy.

Signup and view all the flashcards

How does dehydration in HHNS increase the risk of clotting?

As dehydration intensifies due to osmotic diuresis in HHNS, the blood becomes thicker (hemoconcentrated), increasing the risk of clotting, blood clots (thromboemboli), and blockages in major organs.

Signup and view all the flashcards

Why is prompt medical attention crucial for HHNS?

HHNS is a life-threatening condition that requires prompt medical attention. It is crucial to understand the mechanisms behind this condition and the importance of maintaining proper blood glucose control, hydration, and preventing complications.

Signup and view all the flashcards

Study Notes

Critical Care Nursing Theory: Chapter 11 - Endocrine Disorders (DKA/HHNS)

  • Endocrine disorders covered include Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS).
  • Diabetes Mellitus is a group of diseases affecting how the body uses blood sugar (glucose).
  • Glucose is the main source of energy for muscles, tissues and the brain.
  • Diabetes Mellitus (DM) is a metabolic disorder with hyperglycemia resulting from an absolute or relative lack of insulin or cellular resistance to insulin
  • Major classifications of DM include Type 1 and Type 2 Diabetes.

Diabetes Mellitus/Type 1

  • Definition: Beta cells, located in the pancreas, no longer produce insulin. This leads to hyperglycemia, breakdown of body fats and proteins, resulting in ketoacidosis
  • Prevalence: Accounts for 5-10% of diabetes cases, most commonly occurring in childhood/adolescence.
  • Historical Context (former name): Known as juvenile-onset or insulin-dependent diabetes (IDDM).
  • Pathophysiology: Autoimmune reaction destroys beta cells producing insulin, while alpha cells produce excess glucagon, leading to hyperglycemia.
  • Risk Factors: Genetic predisposition, environmental triggers and viral infections, including (mumps/rubella), and chemical toxins stimulate an autoimmune response.
  • Manifestations: Gradual beta cell destruction leading to hyperglycemia. Often triggered by illness. Results in polyuria (frequent urination), glycosuria (glucose in urine), polydipsia (extreme thirst), polyphagia (increased hunger), weight loss, malaise and fatigue, and blurred vision.
  • Diagnosis: Symptomatic patient, with casual/plasma glucose (non-fasting) levels of 200mg/dL or higher; fasting plasma glucose at 126mg/dL or higher; or two-hour plasma glucose levels of 200mg/dL or higher during an oral glucose tolerance test.

Diabetes Mellitus/Type 2

  • Definition: Fasting hyperglycemia despite the body's own insulin availability classified as non-insulin dependent diabetes, or adult-onset diabetes.
  • Pathophysiology: Sufficient insulin production to prevent DKA, but insufficient to reduce blood glucose levels through muscle and fat cell uptake of glucose. High cellular resistance to insulin due to obesity, inactivity, illness, age, or certain medications.
  • Risk Factors: History of diabetes in parents/siblings, obesity (particularly upper body), physical inactivity, certain racial/ethnic backgrounds (African American, Hispanic, or American Indian origin), history of gestational diabetes in women, polycystic ovary syndrome, birth weight of the baby >9 pounds, hypertension, low HDL cholesterol (<35mg/dL), and high triglycerides (>250mg/dL).
  • Manifestations: Clients are usually unaware of having diabetes when presenting for treatment. Often diagnosed during a health check or when seeking treatment for other issues. Typically do not experience weight loss.

Diabetic Ketoacidosis (DKA)

  • Definition: Absolute/relative insulin deficiency compounded by hyperglycemia, dehydration, and acidosis, causing disturbances in intermediary metabolism resulting in serum acetone.
  • Cause: Absence or severely inadequate insulin levels. Disrupts carbohydrate, protein, and fat metabolism.
  • Clinical Features: Hyperglycemia, dehydration/electrolyte loss, and acidosis
  • Pathophysiology: Marked decrease in insulin and increased glucose production by the liver, leading to hyperglycemia and osmotic diuresis (frequent urination). Reduced glucose use by cells causes the breakdown of fats and proteins for energy release and production of ketone bodies. The accumulation of ketone bodies leads to metabolic acidosis.
  • Causes: Decreased/missed insulin dose, illness/infection, pancreatitis, undiagnosed/untreated diabetes, heart attack, stroke, and certain medications (diuretics/corticosteroids).
  • Treatment: Rehydration, electrolytes restoration, and reversing acidosis with the infusion of insulin.

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

  • Definition: Hyperosmolarity and hyperglycemia, predominating with a decreased sensorium (awareness). Minimal to no ketosis.
  • Cause: Acute metabolic complication of type 2 diabetes typically marked by impaired mental status and higher-than-normal plasma osmolality in a patient with hyperglycemia.
  • Pathophysiology: Insufficient insulin to prevent glucose production resulting in hyperglycemia. Reduced insulin leads to osmotic diuresis. Reduced water and electrolytes lead to dehydration. Counter-regulatory hormones (cortisol/epinephrine) stimulate gluconeogenesis increasing hepatic glucose production.
  • Causes: Severe systemic stress, illness, poor diabetes management, high carbohydrate intake, medications, impaired renal function.
  • Signs: Elevated blood glucose (>600mg/dL), frequent urination/extreme thirst, confusion or sleepiness, unexpected weight loss, warm/dry skin without sweating, and fever.
  • Diagnosis: Based on symptoms, evaluating blood glucose levels (<600mg/dL) and ketone levels. Evaluating serum osmolality.

Hypoglycemia

  • Definition: Serum glucose levels fall below normal amounts, often less than 70mg/dL(non-diagnostic but indicative), and is characterized by Whipple's Triad: Hypoglycemic symptoms, a documented low blood glucose level, symptoms resolving upon glucose correction.
  • Causes: Overmedication with insulin, inadequate carbohydrate intake during insulin administration, increased physical activity, and/or alcohol consumption.
  • Symptoms: Sweating, trembling, tachycardia, respiratory distress, abdominal pain, vomiting, combative/agitated behavior, loss of consciousness.
  • Diagnosis: Based on symptoms, low blood glucose, confirmed resolution of symptoms after blood glucose correction. Measuring glucose levels and reviewing medications/dietary history.
  • Treatment: ABC's, supplemental oxygen, blood glucose monitoring, IV fluids, and supplemental glucose in the form of juices, non-diet sodas, glucose solutions, or D10 bolus. For severe cases, glucagon is administered by intramuscular/subcutaneous injection.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Critical Care Nursing Theory: Endocrine Disorders (DKA/HHNS) 2024 PDF

Description

Test your knowledge on the symptoms, causes, and diagnostic criteria related to hyperglycemia and Type 2 Diabetes Mellitus. This quiz covers important factors such as fasting plasma glucose levels, insulin resistance, and the potential consequences of diabetes. Perfect for students and healthcare professionals alike.

More Like This

Type 2 Diabetes Mellitus Quiz
3 questions

Type 2 Diabetes Mellitus Quiz

RemarkableStarfish6091 avatar
RemarkableStarfish6091
Type 2 Diabetes Mellitus: Pathogenesis and Mechanisms
16 questions

Type 2 Diabetes Mellitus: Pathogenesis and Mechanisms

JoyousTiger avatar
JoyousTiger
Type 1 & 2 Diabetes Mellitus
30 questions

Type 1 & 2 Diabetes Mellitus

EntrancingTheory9758 avatar
EntrancingTheory9758
Use Quizgecko on...
Browser
Open
Browser
Browser