A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss, elevated blood glucose levels, and polyphagia. The gerontology nurse should anticipate which of the following secondary medical diagnoses?
A. Impaired glucose tolerance
B. Gestational diabetes mellitus
C. Pituitary tumor
D. Pancreatic tumor
Correct Answer: D. Pancreatic tumor
The onset of hyperglycemia in older adults can occur more slowly. When the older adult reports rapid-onset weight loss, elevated blood glucose levels, and polyphagia, the healthcare provider should consider pancreatic tumors. Weight loss occurs in about 90% of patients. Approximately 90% of all cases of pancreatic cancer are among people over 55 years of age.
Option A: These patients are usually asymptomatic since they have prediabetes. The family history of diabetes and any previous history of gestational diabetes mellitus should be obtained. If they are diabetic, they will present with polyuria, polydipsia, infections, and neuropathy.
Option B: The clinical features of gestational diabetes mellitus can be varied. The disproportionate weight gain, obesity, and elevated BMI can be suggestive features. The diagnosis is established by the laboratory screening method at the 24 to 28 weeks of pregnancy.
Option C: Pituitary microadenoma is usually an incidental finding on MRI head. Patients are asymptomatic unless the tumor is hormonally active. Pituitary macroadenoma presents with mass effects and potentially hormonal deficiency or hormonal excess.
No comments:
Post a Comment