The nurse is educating a patient with diabetes about long-term complications of the disease. Which of the following complications should the nurse include in the teaching?
Asthma
Osteoporosis
Liver cirrhosis
Cardiovascular disease
The Correct Answer is D
A. Asthma: Asthma is a respiratory condition and is not a common complication associated with diabetes.
B. Osteoporosis: Osteoporosis is a bone disease more commonly associated with hormonal changes, aging, or steroid use, not directly linked to diabetes.
C. Liver cirrhosis: Liver cirrhosis is usually caused by alcohol use, hepatitis, or other liver diseases, not directly due to diabetes.
D. Cardiovascular disease: Diabetes is a significant risk factor for cardiovascular disease due to its association with atherosclerosis, hypertension, and dyslipidemia.
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Correct Answer is A
Explanation
A. Serum sodium levels: Desmopressin can lead to water retention and potentially hyponatremia. Monitoring serum sodium is crucial to prevent electrolyte imbalance.
B. Serum magnesium levels: Magnesium is not typically impacted by desmopressin treatment in central diabetes insipidus.
C. Serum potassium levels: Desmopressin does not generally affect potassium levels in patients with diabetes insipidus.
D. Serum calcium levels: Calcium levels are not directly influenced by desmopressin or diabetes insipidus.
Correct Answer is B
Explanation
A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys. Reduced blood flow to the kidneys, or renal hypoperfusion, decreases the glomerular filtration rate (GFR) because less blood is being filtered through the kidneys. This can occur in conditions such as shock, severe dehydration, or heart failure, but it is not the primary mechanism in acute tubular necrosis (ATN).
B. The glomerular filtration rate decreases because there is injury to the renal tubular cells. In ATN, the injury to renal tubular cells impairs their function, leading to reduced reabsorption and filtration ability, which contributes to the decrease in GFR.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys. While inflammation may be present, it is not the primary cause of decreased GFR in acute tubular necrosis; reduced blood flow and tubular cell injury are more direct causes.
D. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down. Obstruction is not typically a characteristic of acute tubular necrosis; ATN is usually caused by ischemic or toxic injury, not physical obstruction.