Diabetes Mellitus Q 42 - Gyan Darpan : Learning Portal
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Friday 8 April 2022

Diabetes Mellitus Q 42

A patient received 6 units of regular insulin three (3) hours ago. The nurse would be most concerned if which of the following was observed?
    A. Kussmaul respirations and diaphoresis
    B. Anorexia and lethargy
    C. Diaphoresis and trembling
    D. Headache and polyuria

Correct Answer: C. Diaphoresis and trembling

Diaphoresis and trembling indicate hypoglycemia and should be treated immediately. Neurogenic signs and symptoms can either be adrenergic (tremor, palpitations, anxiety) or cholinergic (hunger, diaphoresis, paresthesias). Identification of a hypoglycemic patient is critical due to potential adverse effects, including coma and/or death.

Option A: The patient with diabetic ketoacidosis may present with a myriad of symptoms and physical exam findings. Patients may have symptoms of hyperglycemia like polyphagia, polyuria, or polydipsia. Kussmaul’s breathing, which is labored, deep, and tachypneic, may occur. Some providers may appreciate a fruity scent to the patient’s breath, indicative of the presence of acetone.
Option B: In patients with DM (mainly type 1 but can also be type 2) and on an insulin regimen, blood glucose should be monitored between meals to prevent hypoglycemia. Additionally, weight measurements are necessary due to insulin-associated weight gain.
Option D: Neuroglycopenic signs and symptoms are signs and symptoms that result from direct central nervous system (CNS) deprivation of glucose. These include behavioral changes, confusion, fatigue, seizure, coma, and potential death if not immediately corrected.

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