Today’s NCLEX-RN® question of the day focuses on Diabetic ketoacidosis. Do you know the answer? Let’s find out!
Which patient is at highest risk for development of diabetic ketoacidosis (DKA)?
A. A patient diagnosed with Type II diabetes mellitus (DM) who takes insulin and has worsening renal function
B. An unemployed patient diagnosed with Type I diabetes mellitus (DM) being treated for gastroenteritis
C. A patient diagnosed with diabetes insipidus (DI) following a traumatic brain injury who’s experiencing polydipsia
D. A patient diagnosed with Type I diabetes mellitus (DM) with private health insurance and an implanted insulin pump
Scroll down for the correct answer!
The correct answer to today’s NCLEX® Question is…
B. An unemployed patient diagnosed with Type I diabetes mellitus (DM) being treated for gastroenteritis
Rationale: Patients with Type I DM are at increased risk for DKA due to their body’s inability to produce insulin. Unemployment or having a socioeconomic background with limited access to healthcare resources can increase the risk of developing DKA because of the difficulty in obtaining resources to manage the disease process. Patients with DM who have gastroenteritis are particularly at risk for developing DKA because of vomiting, diarrhea, and/or inability to consume foods/liquids while ill. Additionally, during times of stress or illness, blood glucose levels may increase.
Main Takeaway
Patients with Type I diabetes mellitus (DM), as opposed to Type II DM, are at higher risk for developing DKA. Their risk is increased when they are ill, especially if they are vomiting and/or are unable to consume foods/liquids. Other risk factors include low socioeconomic status, previous incidences of DKA, and elevated hemoglobin A1C.
Incorrect Answer Explanations
A. A patient diagnosed with Type II diabetes mellitus (DM) who takes insulin and has worsening renal function
Rationale: Patients with Type II DM are at decreased risk of developing DKA compared to patients with Type I DM because they may still produce some insulin. Additionally, this patient takes insulin, which decreases the risk of developing DKA.
C. A patient diagnosed with diabetes insipidus (DI) following a traumatic brain injury who’s experiencing polydipsia
Rationale: Diabetes insipidus (DI) is a problem with the body’s ability to balance fluid levels. Blood glucose may be normal in patients with DI, although trauma and stress may cause elevated levels. Polydipsia is one of the symptoms of DM and may also be seen in patients with diabetes insipidus.
D. A patient diagnosed with Type I diabetes mellitus (DM) with private health insurance and an implanted insulin pump
Rationale: Although patients with Type I DM are generally at high risk for developing DKA, patients with an implanted insulin pump have improved glycemic control and are therefore at lower risk for developing DKA. Additionally, private health insurance coverage is a supportive resource that assists the patient in managing the disease process.
Want to learn more about this topic?
Watch the Osmosis video: Diabetic ketoacidosis (DKA): Nursing process (ADPIE)
References
- Brandstaette, E., Bartal, C., Sagy, I., Jotkowitz, A., & Barsk,i L. (2019). Recurrent diabetic ketoacidosis. Archives of Endocrinology and Metabolism, 63(5):531-535. doi: 10.20945/2359-3997000000158.
- Tkacs, N., Herrmann, L., & Johnson, R. (2020). Advanced Physiology and Pathophysiology: Essentials for Clinical Practice. Springer Publishing Company. ISBN: 9780826177087
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