A diabetes education nurse is teaching a group of recently ...

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A diabetes education nurse is teaching a group of recently diagnosed diabetics about the potential genitourinary complications of diabetes and the consequent importance of vigilant blood glucose control.
 
  Which of the following teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus?
  A)
  People with diabetes are highly susceptible to urethral obstructions, and these can heal more slowly and cause more damage than in people without diabetes.
  B)
  High blood sugar results in a high glucose level in your urine, and this can make your bladder muscle less able to fully empty the bladder.
  C)
  Many people with diabetes find it necessary to live with an indwelling catheter to ensure their bladders do not become too full.
  D)
  It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying.

Question 2

Because the associated nephropathy is an important cause of end-stage renal failure in children and adolescents, a toddler who has had an uncomplicated bout of urinary tract infection (UTI) should still be evaluated for
 
  A)
  urethrovesical reflux.
  B)
  vesicoureteral reflux.
  C)
  neurogenic bladder.
  D)
  detrusor muscle instability.

[flexer1n1]

Answer to Question 1

Ans:
D

Feedback:

Diabetics are vulnerable to peripheral neuropathies that can be somewhat mitigated by regular voiding; they are also especially vulnerable to renal damage from high blood sugars, a situation that is worsened when accompanied by incomplete bladder emptying. Urethral obstructions are not a noted complication of diabetes, and indwelling catheter placement is not normally necessary. High blood sugars do not necessarily yield high-glucose urine, and the bladder deficits associated with diabetes are neurological in nature rather than a result of particular urine chemistry.

Answer to Question 2

Ans:
B

Feedback:

Urethrovesical reflux occurs when urine from the urethra moves into the bladder. Vesicoureteral reflux occurs when urine moves from the bladder into the ureter. Vesicoureteral reflux is the most commonly associated abnormality in UTIs. Reflux nephropathy is an important cause of end-stage renal disease in children and adolescents; children with a relatively uncomplicated first UTI may turn out to have significant reflux. Therefore, even a single documented UTI in a child requires careful diagnosis. Functional obstructions include neurogenic bladder, infrequent voiding, detrusor (bladder) muscle instability, and constipation.

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TYSM

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Excellent