You are the nurse caring for a 72-year-old female who is recovering from abdominal surgery on the medical-surgical unit
The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated, yet she has not been diagnosed with diabetes. To what do you attribute this elevation in blood sugars?
A) It is a result of antidiuretic hormone.
B) She must have had diabetes prior to surgery.
C) She has become a diabetic from the abdominal surgery.
D) The blood sugars are probably a result of the "fight-or-flight" reaction.
Ans: D
Feedback: During stressful situations, ACTH stimulates the release of cortisol from the adrenal gland, which creates protein catabolism releasing amino acids and stimulating the liver to convert amino acids to glucose; the result is elevated blood sugars. Option A is incorrect; antidiuretic hormone is released during stressful situations and stimulates reabsorption of water in the distal and collecting tubules of the kidney. Option B is incorrect; assuming the patient had diabetes prior to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. Option C is incorrect; there is no evidence presented in the question other than elevated blood sugars that would support a diagnosis of diabetes.
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