Chapter 19: Endocrine and Hematologic Emergencies

Type 1 diabetes is a condition in which:

• too much insulin is produced.

• glucose utilization is impaired.

• too much glucose enters the cell.

• the body does not produce glucose.

A 45-year-old man with type 1 diabetes is found unresponsive. Which of the following questions is MOST important to ask his wife?

• “Did he take his insulin today?”

  
  

• “How long has he been a diabetic?”

• “Has he seen his physician recently?”

• “What kind of insulin does he take?”

A diabetic patient presents with a blood glucose level of 310 mg/dL and severe dehydration. The patient’s dehydration is the result of:

• excretion of glucose and water from the kidneys.

• a deficiency of insulin that causes internal fluid loss.

• an infection that often accompanies hyperglycemia.

• an inability to produce energy because of insulin depletion.

Which combination of factors would MOST likely cause a hypoglycemic crisis in a diabetic patient?

• Eating a meal and taking insulin

• Skipping a meal and taking insulin

• Eating a meal and not taking insulin

  
  

• Skipping a meal and not taking insulin

A 19-year-old diabetic male was found unresponsive on the couch by his roommate. After confirming that the patient is unresponsive, you should:

• suction his oropharynx.

• manually open his airway.

  
  

• administer high-flow oxygen.

• begin assisting his ventilations.

What breathing pattern would you MOST likely encounter in a patient with diabetic ketoacidosis (DKA)?

• Slow and shallow

• Shallow and irregular

• Rapid and deep

  
  

• Slow and irregular

A woman called EMS because her 12-year-old son, who had been experiencing excessive urination, thirst, and hunger for the past 36 hours, has an altered mental status and is breathing fast. You should be MOST suspicious for:

• low blood sugar.

• hypoglycemia.

• hypoglycemic crisis.

• hyperglycemic crisis.

If the cells do not receive glucose, they will begin to metabolize:

• fat.

• acid.

• sugar.

• ketones.

In contrast to a hyperglycemic crisis, a hypoglycemic crisis:

• rarely presents with seizures.

• presents over a period of hours to days.

• should not routinely be treated with glucose.

• usually responds immediately after treatment.

Patients with diabetic ketoacidosis experience polydipsia because:

• they are dehydrated secondary to excessive urination.

• the cells of the body are starved due to a lack of glucose.

• fatty acids are being metabolized at the cellular level.

• hyperglycemia usually causes severe internal water loss.