Question

A patient's urinalysis indicates the presence of ketonuria. Which of the following additional tests would the nurse reasonably expect the physician to order as a result of the urinalysis?

1) Bone marrow aspiration

2) Intravenous pyelogram

3) Glycosylated or glycated hemoglobin (A1C)

4) Oral glucose tolerance test

Answer 1

The presence of ketonuria would likely prompt tests related to diabetes, such as glycosylated hemoglobin (A1C) and oral glucose tolerance test, as they are related to blood glucose management.

Step-by-step explanation:

The presence of ketonuria in a patient's urinalysis suggests that the body is metabolizing fat instead of glucose for energy, which can happen in the absence of sufficient insulin or in the presence of insulin resistance, both characteristic of diabetes mellitus. Given that ketonuria is often associated with diabetes, a reasonable follow-up test could be a glycosylated hemoglobin (A1C) test, which reflects average blood glucose levels over the past two to three months. Another possible follow-up is an oral glucose tolerance test, which measures how well the body processes a standard amount of glucose. These tests would help in diagnosing and monitoring diabetes more accurately than bone marrow aspiration or an intravenous pyelogram, which are unrelated to diabetes.