chapter 20

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours.

On the basis of this patient's clinical presentation, you should suspect that she:

• has a low blood glucose level.

• has overdosed on her insulin.

• is significantly hyperglycemic.

• has a urinary tract infection.

Classic signs and symptoms of hypoglycemia include:

• cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.

• cool, clammy skin; weakness; tachycardia; and rapid respirations.

• warm, dry skin; hunger; abdominal pain; and deep, slow respirations.

• warm, dry skin; irritability; bradycardia; and rapid respirations.

Diabetes is MOST accurately defined as a(n):

• lack of insulin production in the pancreas.

• disorder of glucose metabolism.

• abnormally high blood glucose level.

• mass excretion of glucose by the kidneys.

Diabetic ketoacidosis occurs when:

• Insulin is not available in the body.

• blood glucose levels rapidly fall

• The pancreas produces excess insulin.

• the cells rapidly metabolize glucose.

Excessive eating caused by cellular "hunger" is called:

• polydipsia

• dyspepsia.

• dysphasia.

• polyphagia.

Hemoglobin is:

• the fluid portion of the blood that transports cells throughout the body.

• found within the red blood cells and is responsible for carrying oxygen.

• essential for the formation of clots, such as when vessel damage occurs.

• a key component of the blood and is produced in response to an infection.

In general, oral glucose should be given to any patient who:

• is unresponsive, even in the absence of a history of diabetes.

• has a blood glucose level that is less than 100 mg/dL.

• has documented hypoglycemia and an absent gag reflex.

• has an altered mental status and a history of diabetes.

Patients with thrombophilia are at an increased risk for:

• acute arterial rupture.

• various cancers.

• hemorrhagic stroke.

• pulmonary embolism.

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:

• supplemental insulin.

• tolbutamide (Orinase).

• diet and exercise.

• glyburide (Micronase).

Patients with uncontrolled diabetes experience polyuria because:

• they drink excess amounts of water due to dehydration

• high blood sugar levels cause permanent kidney damage

• excess glucose in the blood is excreted by the kidneys.

• low blood glucose levels result in cellular dehydration.