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 C
Explanation
A. "I can eat a salad with oil and vinegar dressing":
Explanation: This statement is correct. A salad with oil and vinegar dressing is a healthy option, and the patient does not need to avoid this.
B. "I can cook soup using canned vegetables":
Explanation: This statement is generally acceptable. However, the patient should be aware of the sodium content in canned vegetables and choose low-sodium options to manage fluid retention, which can be a concern in Cushing's syndrome.
C. "I can eat dried fruit for breakfast with my oatmeal":
Explanation: This statement is questionable. Dried fruits may have higher sugar content and can contribute to an increase in calorie intake. In Cushing's syndrome, where there may be weight gain, it's advisable to choose fresh fruits over dried ones.
D. "I can eat baked chicken with green beans for dinner":
Explanation: This statement is correct. Baked chicken with green beans is a healthy and balanced option.
Correct Answer is D
Explanation
A. Flushed skin: Flushed or warm skin is more characteristic of hyperthyroidism, where there is an excess of thyroid hormones.
B. Palpitations: Palpitations or a rapid heartbeat are more characteristic of hyperthyroidism, where there is an excess of thyroid hormones.
C. Bulging eyes: Bulging or protruding eyes, known as exophthalmos, is a characteristic sign of Graves' disease, which is a specific type of hyperthyroidism.
D. Fatigue: This is correct. Fatigue is a common symptom of hypothyroidism, reflecting the overall slowing down of the body's processes.
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