A nurse is teaching an adolescent who has type diabetes mellitus.
Which of the following finding is the nurse priority?
A.
Cholesterol 189mg/dl
B.
Glycosuria.
C.
5%.
D.
pre-prandial blood glucose.124mg/dL. .
The Correct Answer and Explanation is:
The correct answer is B. Glycosuria.
Explanation:
In adolescents with diabetes mellitus, glycosuria (the presence of glucose in the urine) is a significant clinical finding that warrants immediate attention. It indicates that blood glucose levels are high enough that the kidneys are unable to reabsorb all the glucose filtered through the glomeruli, resulting in glucose spilling into the urine. This finding suggests poor glycemic control and possibly hyperglycemia, which can lead to serious complications if left unmanaged.
Type 1 diabetes mellitus (T1DM) is characterized by the destruction of pancreatic beta cells, leading to a lack of insulin production. Insulin is required for glucose uptake by the cells. Without adequate insulin, glucose builds up in the bloodstream, leading to hyperglycemia. Glycosuria is a sign that blood glucose levels have surpassed the renal threshold (approximately 180 mg/dL), which means that glucose is being excreted in the urine.
Prioritization Rationale:
In the context of diabetes, managing blood glucose levels is critical. Glycosuria can be an indicator of diabetic ketoacidosis (DKA), a life-threatening condition where the body begins to break down fat for energy, producing ketones, which can lead to metabolic acidosis. Early signs of DKA include polyuria, polydipsia, and glycosuria. If glycosuria is present, the nurse should investigate further for other signs of DKA, such as ketonuria, dehydration, and abdominal pain.
- Cholesterol of 189 mg/dL is within a normal range (less than 200 mg/dL) and does not indicate immediate risk.
- Pre-prandial blood glucose of 124 mg/dL is also within the target range for adolescents with diabetes, usually between 70 and 130 mg/dL.
- The 5% provided is ambiguous, but it could refer to HbA1c. A 5% HbA1c indicates excellent glycemic control, which is not a priority concern.
Thus, glycosuria is the priority finding because it signals the need for urgent intervention to prevent further complications.