You are the nurse caring for a 72-year-old woman who is recovering from a hemicolectomy on the postsurgical unit
The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated, yet diabetes does not appear in her previous medical history. To what do you attribute this elevation in blood sugars?
A) It is a temporary result of increased secretion of antidiuretic hormone.
B) She must have had diabetes prior to surgery that was undiagnosed.
C) She has suffered pancreatic trauma during her 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. Antidiuretic hormone is released during stressful situations and stimulates reabsorption of water in the distal and collecting tubules of the kidney. Assuming the patient had diabetes prior to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. No evidence presented in the question other than elevated blood sugars would support a diagnosis of diabetes.
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