Ms. G is a 40-year-old diabetic who is a professional with a hectic schedule. She has difficulty controlling her blood sugar because she eats out frequently and consumes large amounts of calories from fast food
You suspect that she also enjoys being able to overeat while continuing to lose weight. At her last three clinic visits the provider discussed the importance of good glucose control but today her blood sugar was again 320 and a dipstick for ketones in her urine was positive, a condition referred to as ketoacidosis. You explain that: 1. Uncontrolled glucose resulting in ketoacidosis is a very serious medical problem that can lead to comma or even death.
2. Ketones are a by-product of glucose metabolism and occur in varying amounts in the urine depending on the caloric intake of the client.
3. Ketones are naturally found in large numbers in the urine and are not a sign of pathology.
4. Ketoacidosis results when there is an over compensation of insulin by the body in response to a large consumption of complex carbohydrates.
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Rationale: Uncontrolled ketoacidosis is a serious medical problem that can lead to coma and/or death if not corrected. Ketones are a by-product of fat metabolism, a source of energy used by the body when glucose is not available due to insufficient amounts of insulin or starvation. Ketones are eliminated by the kidneys at a rate that is slower than they are produced and can be measured in the blood and/or urine as an indicator of fat catabolism. Ketoacidosis refers to a state in which there are metabolic alterations including altered blood pH and fluid and electrolyte imbalances.
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