Endocrine System Disorders Q 3 - Gyan Darpan : Learning Portal
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Sunday, 10 April 2022

Endocrine System Disorders Q 3

A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:
    A. “The test needs to be repeated following a 12-hour fast.”
    B. “It looks like you aren’t following the prescribed diabetic diet.”
    C. “It tells us about your sugar control for the last 3 months.”
    D. “Your insulin regimen needs to be altered significantly.”

Correct Answer: C. “It tells us about your sugar control for the last 3 months.”

The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control, and it doesn’t require a fasting period before blood is drawn. The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.

Option A: The hemoglobin A1c (glycated hemoglobin, glycosylated hemoglobin, HbA1c, or A1c) test is used to evaluate a person’s level of glucose control. The test shows an average of the blood sugar level over the past 90 days and represents a percentage. The test can also be used to diagnose diabetes.
Option B: The venous sample A1c test may be used as a diagnostic tool in clinical practice when determining diabetes risk or onset. Due to the variability of capillary point of care testing, any A1c done by capillary sample should be confirmed with a venous sample before rendering the diagnosis.
Option D: There are several conditions where the A1c test can produce inaccurate results. People diagnosed with sickle cell anemia, thalassemia, anemia, kidney failure, liver disease, or patients receiving blood transfusions can experience altered results due to the longevity of the red blood cell. A1c tests in these patients must be interpreted with caution and should be confirmed with plasma glucose samples to diagnose diabetes.

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