A 72-year-old female is recovering from abdominal surgery on the medical-surgical unit. The surgery was very stressful and prolonged; the nurse notes on the chart that her blood sugars are elevated yet she has not been diagnosed with diabetes
The nurse realizes:
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, ACT H stimulates the release of cortisol from the adrenal gland, creating protein catabolism which releases amino acids and stimulates 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 blood sugars are elevated that would support a diagnosis of diabetes.
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