A woman with poorly controlled type 1 diabetes has been admitted ...

[littleanan]

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options.
 
  A) Decrease in pH
  B) Breakdown of triglycerides
  C) Low serum insulin levels
  D) Ketone production by the liver
  E) Production of fatty acids and glycerol

Question 2

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide?
 
  A)
  While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it.
  B)
  Ulcers like yours do not penetrate all layers of the stomach or duodenum, so you don't have to worry about losing too much blood.
  C)
  Your family history, your smoking history, and NSAID use may all have contributed to this problem.
  D)
  While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled.

[Athena23]

Answer to Question 1

Ans:
C, B, E, D, A

Feedback:

During ketoacidotic episodes, the lack of insulin leads to mobilization of fatty acids from adipose tissue because of the unsuppressed adipose cell lipase activity that breaks down triglycerides into fatty acids and glycerol. The increase in fatty acid levels leads to ketone production by the liver and ultimately metabolic acidosis.

Answer to Question 2

Ans:
C

Feedback:

Family history, NSAID use, and smoking have all been identified as contributing factors in the development of peptic ulcers. Diet therapy has not been shown to be effective, and duodenal peptic ulcers are more common than the gastric variant. Perforation occurs when an ulcer erodes through all layers of the stomach or duodenum wall. When perforation occurs in older adults, their mortality is significantly increased. Effective medication regimens are available with antacids, H2-receptor antagonists or proton pump inhibitors being the most common medications used.