Tom is an 18-year-old high school student who came to the clinic with complaints of frequent urination. He has been feeling more tired than usual. He reports losing 13 pounds unintentionally in the past three months, and is more hungry than usual
Lab results showed no bacteria or white blood cells in the urine, but ketones were present. The CBC was normal with no elevation in white blood cells. A metabolic profile was normal except for glucose which was 132. At his follow-up visit the nurse should ask about: 1. Recent weight gain, sexual activity, and frequent thirst.
2. A family history of diabetes, recent weight gain, and blurred vision.
3. Recent weight loss, frequent thirst, and increased hunger.
4. A family history of diabetes, lack of thirst, and recent weight loss.
3
Rationale: Urinary tract infections can cause increased urination but are uncommon among adolescent males, and when they occur the causative agent is often E coli, resulting from anal sex. The nurse should inquire about a family history of diabetes and blurred vision which is a symptom of hyperglycemia if diabetes is suspected. Lack of thirst is not a symptom of diabetes.
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