A client is newly diagnosed with type 2 diabetes mellitus. Which ...

[waynest]

A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best evalu-ate the management plan prescribed for this client?
 
  a. A yearly funduscopic examination by an ophthalmologist
  b. Regular foot examinations by a podiatrist
  c. Quarterly hemoglobin A1C
  d. Biannual cholesterol testing

Question 2

Hyperglycemia is harder to detect in older adults due to which of the following?
 
  a. There is a higher tolerance for elevated levels of circulating glucose in older adults.
  b. Older adults tend to metabolize glucose at a faster rate than younger adults.
  c. Fingerstick glucose monitoring is inaccu-rate in older adults.
  d. The classic signs of elevated glucose lev-els, polyuria, polyphagia, and polydipsia are rarely present in older adults.

[aham8f]

Answer to Question 1

ANS: C
Quarterly or biannual hemoglobin A1C (Hb A1C) is designed to provide information regarding the averaged glucose levels for a 3-month period of time. The periodic measurement of a glycated hemoglobin test (Hb A1C) is the best measure of ongoing glycemic control. Eye examinations are important, but proper blood sugar control will help prevent the damaging effects of diabetes to the eyes. Proper foot care is important, but good blood sugar control will help prevent the dam-aging effects of diabetes on the feet. Biannual cholesterol testing is not relevant to the evaluation of type 2 diabetes mellitus.

Answer to Question 2

ANS: A
Hyperglycemia in older adults is harder to detect than in a younger adult. With aging there is a higher tolerance for elevated levels of circulating glucose. It is not unusual to find persons with fasting glucose levels of 200-600 mg/dL or higher. It is not true that older adults metabolize glu-cose at a faster rate than younger adults or that fingerstick glucose monitoring is inaccurate in older adults. While it is true that older adults usually do not have the classic symptoms of ele-vated glucose levels, this does not explain why hyperglycemia is harder to detect in older adults.

[waynest]

Gracias!

[brbarasa]

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