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 B
Explanation
A. Urinalysis shows trace protein:
Explanation: While trace protein in the urine is generally better than higher levels, it doesn't provide a specific measure of blood glucose control. Protein in the urine can be an early sign of kidney damage in diabetes, but it doesn't directly indicate blood glucose control.
B. Hemoglobin A1C of 5.6%:
Explanation: Hemoglobin A1C (HbA1C) is a long-term indicator of blood glucose control. An HbA1C level of 5.6% is within the target range for individuals with diabetes and suggests good control of blood glucose over the past 2-3 months.
C. Fasting blood glucose of 110 mg/dL:
Explanation: Fasting blood glucose gives a snapshot of blood glucose at a specific moment. While 110 mg/dL is a fairly normal fasting level, it doesn't provide information about long-term control. A single fasting glucose measurement may not reflect overall glucose management.
D. Urine ketones are negative:
Explanation: Negative urine ketones indicate that the body is not currently using fat for energy. While this is a good sign in the moment, it doesn't give information about overall blood glucose control over time. Urine ketones can fluctuate based on various factors, including diet and activity level.
Correct Answer is C
Explanation
A. "I will make sure I call the diabetes educator each time I adjust my insulin dose."
This statement suggests a reliance on insulin adjustment and implies frequent contact with the diabetes educator. However, it doesn't address the primary treatment for type 2 diabetes.
B. "I read that a pancreas transplant will provide a cure for my diabetes."
This statement mentions a pancreas transplant, which is a significant and rare intervention typically reserved for severe cases of diabetes. However, it's not considered the primary treatment for type 2 diabetes.
C. "I will make sure to follow the weight loss plan designed by the dietitian."
This statement aligns with a key aspect of managing type 2 diabetes, as weight management, along with diet and exercise, is a primary approach. Lifestyle modifications, including weight loss, are often part of the primary treatment plan.
D. "I will take my oral anti-diabetic agents when my morning blood sugar is high."
This statement indicates an understanding of the importance of oral anti-diabetic agents, which are commonly used in the management of type 2 diabetes. Timing medication based on blood sugar levels is a key aspect of treatment.
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