An insulin-dependent patient who is admitted to the same-day surgical suite for carpal tunnel surgery may be at risk for which of the following metabolic disorders?
A) Adrenal insufficiency
B) Thyrotoxicosis
C) Impaired acid-base balance
D) Hyperglycemia
Ans: D
Chapter: 18
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 2
Patient Needs: B-2
Feedback: Hyperglycemia during the surgical procedure is a risk based on the body's defense mechanism to raise the blood sugar in the event of stress. Patients who have received corticosteroids are at risk of adrenal insufficiency. Patients with uncontrolled thyroid disorders are at risk for thyrotoxicosis. Because the kidneys are involved in excreting anesthetic medications and their metabolites, and because acid-base status and metabolism are also important considerations in anesthesia administration, surgery is contraindicated when a patient has acute nephritis, acute renal insufficiency with oliguria or anuria, or other renal problems.
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