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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is ["A","D","E"]

Explanation

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.

A. with the meal B. post-prandial C. pre-prandial D. AC/HS

Correct Answer is A

Explanation

A. With the meal:
Insulin Lispro is a rapid-acting insulin that is designed to be taken just before or with meals.
It helps control the rise in blood sugar that occurs after eating.

B. Post-prandial:
"Post-prandial" refers to after a meal. Insulin Lispro is usually administered before or with a meal to cover the increase in blood glucose that happens after eating.

C. Pre-prandial:
"Pre-prandial" refers to before a meal. This is accurate for Insulin Lispro, as it is given shortly before or with meals.

D. AC/HS:
"AC" stands for "ante cibum," which means before meals, and "HS" stands for "hora somni," which means at bedtime. This terminology is more commonly associated with the timing of oral medications rather than insulin.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

Correct Answer is ["A","D","E"]

Explanation

The nurse is preparing to administer Insulin Lispro (Humalog) to a client with Type 2 Diabetes Mellitus for carbohydrate coverage. The nurse understands the injection should be administered:

Correct Answer is A

Explanation

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