A patient with type 2 diabetes achieves adequate glycemic control through diet and exercise
Upon being admitted to the hospital for a cholecystectomy, however, the patient has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?
A) Alterations in bile metabolism and release have likely caused hyperglycemia.
B) Stress has likely caused an increase in the patient's blood sugar levels.
C) The patient has likely overestimated her ability to control her diabetes using nonpharmacologic measures.
D) The patient's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
Ans: B
Feedback:
During periods of physiologic stress, such as surgery, blood glucose levels tend to increase, because levels of stress hormones (epinephrine, norepinephrine, glucagon, cortisol, and growth hormone) increase. The patient's need for insulin is unrelated to the action of bile, the patient's overestimation of previous blood sugar control, or fluid imbalance.
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