Diabetes Mellitus Overview Quiz
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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</p> Signup and view all the answers

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

    <p>Obesity</p> Signup and view all the answers

    What defines Type 2 Diabetes Mellitus?

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

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

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

    Which factor is NOT a known cause of DKA?

    <p>Increased physical activity</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.</p> Signup and view all the answers

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

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

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

    <p>Corticosteroids</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</p> Signup and view all the answers

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

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

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

    <p>Hypoglycemia</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</p> Signup and view all the answers

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

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

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

    <p>Lipolysis</p> Signup and view all the answers

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

    <p>Both Type I and Type II Diabetes</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.</p> Signup and view all the answers

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

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

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

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

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

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

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

    <p>Blood becoming acidic</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.</p> Signup and view all the answers

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

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

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

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

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

    <p>Cortisol</p> Signup and view all the answers

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

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

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

    <p>Stroke</p> Signup and view all the answers

    What is the consequence of hemoconcentration in HHNS patients?

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

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

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

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

    <p>Corticosteroids</p> Signup and view all the answers

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

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

    Which of the following factors can precipitate HHNS?

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

    What potential consequence may arise from untreated HHNS?

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

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

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

    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.

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    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.

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