Question about metabolic acidosis

[EmilyEmily]

[h=3]Which actions by a person with type 2 diabetes increase the risk for developing metabolic acidosis?[/h]Answer is ??

a( drinking 2 liters of water and then engaging in aerobic exercise

B) drinking sodium bicarb after every meal to manage chronic indigestion

C) taking the prescribed does of long-acting insulin in the morning and then skipping lunch

D) skipping the prescribed insulin doses for a week while adhering to an 1800 calorie diet.

I'm thinking it's D.

fyi: this is not homework, this is a question off of quizlet.

[JustBeachyNurse, LPN]

Why do you think D? Then we can guide you.

[EmilyEmily]

Why do you think D? Then we can guide you.

Because missing insulin doses can cause diabetic ketoacidosis

[Esme12, ASN, BSN, RN]

essentially yes.....technically skipping their meds will cause a rise in blood sugar. How does an elevated glucose cause acidosis that can lead to DKA? What is DKA?

[JustBeachyNurse, LPN]

However type 2 diabetics still produce some insulin (even if ineffectively) and are significantly less at risk for DKA. Type 2 are more at risk for non-ketone hyperosmilic coma.

The not taking insulin combined with an 1800 kCal ADA diet does not increase the risk of DKA but lowers it

[Esme12, ASN, BSN, RN]

If the type 2 is on insulin they are just as likely to develop ketoacidosis.....DKA mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes....it remains the same complex disordered metabolic state characterized by the same hallmarks as DKA.....hyperglycemia, ketoacidosis, and ketonuria.

[EmilyEmily]

I'm thinking the answer may be A now because my book says that Diabetics should eat a snack an hour before heavy exercise

[Esme12, ASN, BSN, RN]

Which will increase the glucose in the blood to dangerous levels?

Why should Diabetics eat a snack before exercise? What do muscles use for energy? Would the muscles use a lot of "food" during exercise causing a DROP of serum glucose?

But I see what you are saying it says metabolic acidosis.. not ketoacidosis..

Which actions by a person with type 2 diabetes increase the risk for developing metabolic acidosis?.

there is a build up of lactic acid in the muscles with exercise that would be greater if there isn't enough fuel to feed the muscles....leading to metabolic acidosis from lactic acid.

Hummmm....good question......

[KelRN215, BSN, RN]

I'm thinking the answer may be A now because my book says that Diabetics should eat a snack an hour before heavy exercise

Why do they eat a snack before exercise? To prevent them from developing hyperglycemia or hypoglycemia?

[Lexirunner]

Snack = glucose. Glucose = aerobic metabolism. But if diabetic, you need exogenous insulin (not always in DM2) to facilitate the transfer of glucose into the cell.

I'd like some ABG's.

[nurseprnRN, BSN, RN]

All we need to know is the metabolic acidosis part, presumably diagnosed by ABGs.

OP, you need a little better understanding of what diabetic ketoACIDOSIS is, whether or not it's a metabolic acidosis, and what provokes it. Then you'll have this one figured out.