Nokea
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.
Correct Answer: D
Rationale: 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.
You may also like to solve these questions
What should you encourage the patient to consider?
- A. Improve his nutritional intake.
- B. Make an appointment at a wellness clinic.
- C. Walk on a daily basis.
- D. Increase his interaction with his social network.
Correct Answer: D
Rationale: Social networks can reduce stress by providing the individual with a positive social identity, emotional support, material aide, information, and new social contacts. Changes to diet and activity may be beneficial, but social interaction is known to be of particular benefit. Attendance at a wellness clinic may or may not be beneficial, and does not involve social interaction.
What could the nurse do to help the patient?
- A. Refer him to a consciousness-raising group.
- B. Refer him to a psychiatrist.
- C. Refer him to a support group.
- D. Refer him to a church or temple.
Correct Answer: C
Rationale: Being a member of a group with similar problems or goals has a releasing effect on a person that promotes freedom of expression and exchange of ideas. Psychiatry may or may not be necessary. Spiritual assessment would necessarily precede any referral to a specific religious setting. Consciousness-raising groups are not known to be a common source of social support.
In a state of chronic arousal, what can happen within the body?
- A. Blood pressure decreases.
- B. Serum glucose levels drop.
- C. Arteriosclerosis may develop.
- D. Tissue necrosis may occur.
Correct Answer: C
Rationale: If the sympathetic-adrenal-medullary response is prolonged or excessive, a state of chronic arousal develops that may lead to high (not low) blood pressure, arteriosclerotic changes, and cardiovascular disease. If the production of ACTH is prolonged or excessive, behavior patterns of withdrawal and depression are seen. In addition, the immune response is decreased, and infections and tumors may develop.
What positive outcome of providing the patient with information should the nurse expect?
- A. Increased concentration
- B. Decreased depression levels
- C. Sharing of personal details
- D. Building interdependent relationships
Correct Answer: A
Rationale: Giving patients information also reduces the emotional response so that they can concentrate and solve problems more effectively. Educating the patient does not decrease depression levels or build interpersonal relationships. Educating the patient does not mean sharing of personal details.
Which of the following is an immediate physiologic response to stress the nurse would expect this patient to experience?
- A. Vasodilation of peripheral blood vessels
- B. Increased blood pressure
- C. Decrease in blood glucose levels
- D. Pupil constriction
Correct Answer: B
Rationale: An initial response to stress, as seen by the fight-or-flight response, is an increase in the patients heart rate and blood pressure. Vasoconstriction leads to the increase in blood pressure. Blood glucose levels increase, supplying more readily available energy, and pupils dilate.