A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?
Stress has likely caused an increase in the client's blood sugar levels.
The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures.
Alterations in bile metabolism and release have likely caused hyperglycemia.
The Correct Answer is A
A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.
B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.
C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.
D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Avoid the use of moisturizing lotions.
This statement is not a priority instruction. Moisturizing lotions, especially those designed for diabetic foot care, can help prevent dry skin and complications. However, it's crucial to choose appropriate, diabetes-friendly moisturizers.
B. Examine feet weekly for redness, blisters, and abrasions.
This is an important and relevant instruction. Regular foot inspections help detect any signs of injury or infection early, preventing complications, especially for individuals with peripheral neuropathy.
C. Dry feet vigorously after each bath.
This statement is not advisable. Vigorous drying can potentially harm the skin, especially for individuals with diabetes. A gentle and thorough drying is recommended to prevent skin damage.
D. Avoid hot-water bottles and heating pads.
This is a priority instruction. Patients with peripheral neuropathy may have reduced sensation in their feet, making them more susceptible to burns. Avoiding sources of excessive heat helps prevent injuries.
Correct Answer is B
Explanation
A. Monitoring the patient's breathing and reviewing the patient's arterial blood gases:
Rationale: While respiratory status is crucial in any patient assessment, arterial blood gases primarily evaluate respiratory function. Neutropenia directly affects the immune system, not respiratory function.
Appropriateness: Not directly related to assessing neutropenia.
B. Monitoring the patient's temperature and reviewing the patient's complete blood count with differential:
Rationale: Neutropenia can cause fever due to the increased risk of infection. Monitoring temperature and reviewing the complete blood count (CBC) with differential, specifically the neutrophil count, is essential in evaluating neutropenia and identifying potential infections.
Appropriateness: Correct. Monitoring temperature and reviewing CBC with differential are crucial in assessing neutropenia.
C. Monitoring the patient's blood pressure and reviewing the patient's hematocrit:
Rationale: Blood pressure assessment and hematocrit evaluation are essential aspects of general patient care but are not specific to neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
D. Monitoring the patient's heart rate and reviewing the patient's hemoglobin:
Rationale: Heart rate monitoring and hemoglobin assessment are crucial in various clinical situations but are not specific indicators of neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
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