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 A
Explanation
A. Respiratory acidosis:
This occurs when there is inadequate removal of carbon dioxide (CO2) by the respiratory system. In the case of the patient post-op from knee surgery receiving Morphine, the opioid can cause respiratory depression, leading to the retention of CO2 and the development of respiratory acidosis. Signs include a decreased respiratory rate and drowsiness.
B. Hypokalemia:
This is a condition characterized by low levels of potassium in the blood. While opioids can cause constipation, they are not directly associated with hypokalemia.
C. Metabolic acidosis:
This occurs when there is an increase in acid production or a loss of bicarbonate, leading to an imbalance in the body's acid-base status. The symptoms of metabolic acidosis are not typically associated with opioid use.
D. Respiratory alkalosis:
This occurs when there is excessive elimination of CO2, leading to decreased carbon dioxide levels in the blood. Opioids, especially in higher doses, are more likely to cause respiratory depression and acidosis rather than alkalosis. The patient's low respiratory rate and drowsiness are indicative of respiratory acidosis rather than alkalosis.
Correct Answer is ["B","C","E"]
Explanation
A. Buffalo hump:
Explanation: A buffalo hump is associated with excess cortisol, which is not a typical manifestation of Addison's disease. Instead, patients with Addison's disease may experience weight loss and muscle wasting.
B. Hyponatremia:
Explanation: Correct. Hyponatremia (low sodium levels) can occur in Addison's disease due to the loss of aldosterone, which plays a role in sodium and water balance.
C. Decreased glucose level:
Explanation: Correct. Addison's disease can lead to hypoglycemia (low blood glucose levels) because cortisol, which is important for maintaining blood glucose, is deficient.
D. Weight gain:
Explanation: Weight gain is not a typical manifestation of Addison's disease. Instead, weight loss and muscle wasting may occur.
E. Craving for salt:
Explanation: Correct. Addison's disease can lead to salt craving, as aldosterone deficiency results in increased sodium loss and potassium retention.
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