Question

Carbohydrates are the main sources of fuel for the body. They’re broken down into glucose, which
is “burned” as fuel for the body.
i. What is expected to occur when the body’s supply of glucose runs out?
ii. Would insulin or glucagon be of any importance in this regard? Explain your answer.
iii. As a nurse on duty, a patient is brought to the emergency ward with symptoms of weakness,
dizziness, headache and slight disorientation. The patient has a history of diabetes. Give a
step by step description of what you will do to take care of this patient. What would you
say was the problem with this patient? Is there any remedy to salvage the patient’s
situation?
iv. What are some of the physical presentations of long-term complications of diabetes?
(Mention and explain any two)
v. A postpartum woman has just been told that her new born is G6PD positive. What advice
would you give as her nurse on how to take care of this child?

2. (a) If a person is deficient in Vitamin B6, what is the consequence? How does this deficiency affect
amino acid metabolism?
(b) Briefly describe and explain what happens when there is a defect in phenylalanine metabolism.
(c) A patient presents with symptoms of blurred vision, tremors, and has difficulty speaking. Lab
tests reveal increased levels of ammonia and upon further questioning, you find out that he is an
alcoholic. What is wrong with this patient, and how will you as a nurse manage him?

Answer 1

1. a. When our body's supply of glucose runs out, the blood sugar level drops and pancreas stops producing insulin inorder to prevent further drop in blood sugar levels and the body starts using glycogen which is stored in the liver and muscles . the glycogen is converted into glucose , a process known as glycogenolysis.

b. Yes, insulin and glucagon plays an important role when our blood sugar levels drop. Our pancreas stops producing insulin and glucagon is produced by pancreas which helps to raise the blood sugar levels by stimulating the liver cells to convert the glycogen stored into glucose .

c. The patient is experiencing a state of hypoglycemia. He has to be started with intravenous administeration of dextrose solution and if he is conscious , foods or drinks containing carbohydrates has to be given inorder to raise the blood glucose levels. If left untreated, this can lead to hypoglycemic shock which can prove fatal.

d. Long term complications of Diabetes :

1. Diabetic retinopathy : There is damage to the blood vessels of retina which causes impaired vision . This happens when the person has long history of diabetes or due to poorly controlled blood sugar levels.
2. Diabetic Nephropathy : There is a damage to the kidneys which affects the kidneys ability to remove the toxins from the body. This is also due to the long history of type 1 or 2 diabetes or due to poorly controlled diabetes.

e. G6PD positive means that the baby is deficient in an enzyme called glucose -6-phosphate dehydrogenase which is necessary to protect the  red blood cells from injury.  G6PD positive babies may require phototherapy and exchange transfusion as they usually suffer from hemolytic anemia. This has to be informed to the mother. The baby may also need oxygen therapy . Mother has to be informed about the signs and symptoms of jaundice and its need to be treated with phototherapy. If jaundice is untreated, it may lead to condition called as kernicterus, a complication affecting brain and causing permanent damage of brain. Covering of eyes and reproductive parts during phototherapy should also be informed to the mother to avoid damage to the organs.

Thank you.