The nurse is preparing to teach a client with type 1 diabetes ...

[cmoore54]

The nurse is preparing to teach a client with type 1 diabetes mellitus on the mechanism behind the development of ketoacidosis. List the order in which the nurse should provide this information.
 
  1. Production of lactate and hydrogen ions
  2. Tissue hypoxemia
  3. Breakdown of fatty tissue
  4. Reduction in intracellular glucose
  5. Fatty acids converted to ketones

Question 2

A client being treated for cancer has a tumor designation of Stage IV, T4, N3, M1. What does this staging indicate to the nurse?
 
  A) The tumor will respond to chemotherapy.
  B) The tumor is small in size.
  C) The tumor has metastasized with lymph node involvement.
  D) There is one single tumor to treat.

[lin77x]

Answer to Question 1

Answer: 2, 1, 4, 3, 5

Lactic acidosis develops due to tissue hypoxia and a shift to anaerobic metabolism by the cells. Lactate and hydrogen ions are produced, forming lactic acid. Starvation or lack of insulin leads to intracellular starvation of glucose. The lack of glucose or insulin to move glucose into the cells causes the body to break down fatty tissue to meet metabolic needs. When fatty acids are broken down, these acids are converted to ketones, leading to the development of ketoacidosis.

Answer to Question 2

Answer: C
T refers to the depth of invasion. N refers to the absence or presence and extent of lymph node involvement. M refers to presence of metastasis. The numbers range from 0 to 4, with higher numbers indicating increased size and metastasis. Stage IV indicates metastasis. The staging system is not used to determine tumor response to chemotherapy.