A nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. What clinical findings does the nurse anticipate when assessing the child? Select all that apply.

A. Insulin is responsible for lowering blood glucose levels by promoting the uptake and storage of glucose in cells.

B. Epinephrine (adrenaline) can raise blood glucose levels in response to the "fight or flight" stress response, but it's not primarily responsible for stimulating liver glycogenolysis.

C. Glucagon is produced by the alpha cells in the islets of Langerhans and plays a crucial role in increasing blood glucose levels. It promotes the breakdown of glycogen (glycogenolysis) in the liver and the production of glucose from non-carbohydrate sources (gluconeogenesis).

D. Adrenocorticotropic hormone (ACTH) is produced by the anterior pituitary gland and stimulates the adrenal cortex to release cortisol, which can also contribute to raising blood glucose levels but isn't primarily responsible for liver glycogenolysis.

In the context of diabetes management, understanding the role of glucagon is important because it helps individuals know how to manage hypoglycemia (low blood sugar) by administering glucagon or consuming fast-acting sources of glucose.

A. Checking urine for glucose and protein is not directly related to the care of a child with a VP shunt. The focus is on monitoring the child for signs of complications related to the shunt.

B. Administering narcotics for pain control may be indicated if the child is in pain, but it is not the primary action and should be determined based on the child's pain assessment.

C. Testing cerebrospinal (CSF) fluid leakage for protein is not typically a nursing responsibility in the immediate postoperative period. Leakage of CSF should be reported to the healthcare provider, and diagnostic tests would be conducted by medical staff as needed.

D. Monitor for increased temperature.

Monitoring for an increased temperature is essential because postoperative fever could be an early sign of infection or complications related to the VP shunt. Infection and shunt malfunction are potential risks in the postoperative period.