Diabetes Mellitus Q 38

---

When reviewing the urinalysis report of a client with newly diagnosed diabetes mellitus, the nurse would expect which urine characteristics to be abnormal? Select all that apply.

  

    A. Amount.

    B. Odor.

    C. pH.

    D. Specific gravity.

    E. Glucose level.

    F. Ketone bodies.

Correct Answer: A, B, E, & F.

---

Diabetes mellitus is associated with increased amounts of urine, a sweet or fruity odor, and glucose and ketone bodies in the urine. It does not affect the urine’s pH or specific gravity.

---

Option A: Excessive thirst and increased urination are common diabetes signs and symptoms. When the client has diabetes, excess glucose — a type of sugar — builds up in the blood. The kidneys are forced to work overtime to filter and absorb the excess glucose.

Option B: Strong sweet-smelling urine is a sign of advanced diabetes, which can be diagnosed with urinalysis. With advanced diabetes, sugar and ketones, which are normally absent, can accumulate in the urine and create a strong odor.

Option C: A diet that includes too many acid-producing foods, such as protein or sugar, can cause acidity in the urine as well as other negative health effects. This may cause a type of kidney stone called uric acid stones to form.

Option D: In uncontrolled diabetic patients, the urine specific gravity might reach 1.045 to 1.050 as a result of the loss of glucose in the urine. Specifically, in a patient with poor glycemic control elevated blood glucose levels should result in an increased urine specific gravity.

Option E: In diabetic patients, the kidneys are more susceptible to the effects of hyperglycemia; many of the kidney cells are unable to decrease glucose transport rates and unable to prevent intracellular hyperglycemia in an increased glucose concentration state.

Option F: If cells don’t get enough glucose, the body burns fat for energy instead. This produces a substance called ketones, which can show up in the blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death.

---