Glucose Practice Questions - Metabolism

Considering the presence of diabetes but treating the child similarly to other children

A 9-year-old child has the diagnosis of type 1 diabetes. What intervention should be included in the school nurse's plan of care for this child? 1 Limiting fluid intake during school hours 2 Asking the child each day what was eaten for breakfast 3 Considering the presence of diabetes but treating the child similarly to other children 4 Checking several times a day for injuries because of participation in the physical education program

Presence of infection stress will increase but rarely cause DKA

A nurse is caring for a postoperative client with diabetes. Which is the most common cause of diabetic ketoacidosis that the nurse needs to consider when caring for this client? 1 Emotional stress 2 Presence of infection 3 Increased insulin dose 4 Inadequate food intake

Morning sickness may result in decreased food intake.

A client at 6 weeks' gestation who has type 1 diabetes is attending the prenatal clinic for the first time. The nurse explains that during the first trimester insulin requirements may decrease for what reason? 1 Body metabolism is sluggish in the first trimester. 2 Morning sickness may result in decreased food intake. 3 Fetal requirements of glucose in this period are minimal. 4 Hormones of pregnancy increase the body's need for insulin.

Protein anabolism Glucocorticoids help maintain blood glucose and liver and muscle glycogen content. A deficiency of glucocorticoids causes hypoglycemia, resulting in breakdown of protein and fats as energy sources. Muscular weakness and fatigue are related to fluid balance, but emaciation is not. Emaciation results from diminished protein and fat stores and hypoglycemia, not from an alteration in electrolytes. Masculinization does not occur in this disease.

A client is admitted to a medical unit with a diagnosis of Addison disease. The client is emaciated and reports muscular weakness and fatigue. Which disturbed body process does the nurse determine is the root cause of the client's clinical manifestations? 1 Fluid balance 2 Electrolyte levels 3 Protein anabolism 4 Masculinizing hormones

2 Dry skin 4 Increased thirst 5 Deep, rapid breathing

A nurse is caring for a school-aged child with type 1 diabetes and determines that the child is experiencing an episode of hyperglycemia. What assessments led the nurse to this conclusion? Select all that apply. 1 Irritability 2 Dry skin 3 Diaphoresis 4 Increased thirst 5 Deep, rapid breathing

To identify pending hypoglycemia or hyperglycemia

A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client? 1 To perform foot care daily 2 To administer insulin as prescribed 3 To test urine for both sugar and acetone 4 To identify pending hypoglycemia or hyperglycemia

"The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." hypoglycemia for the finger

A client is learning alternate site testing (AST) for glucose monitoring. Which client statement indicates to the nurse that additional teaching is necessary? 1 "I need to rub my forearm vigorously until warm before testing at this site." 2 "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." 3 "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels." 4 "I have to make sure that my current glucose monitor can be used at an alternative site."

Increased blood glucose

A client is receiving dexamethasone to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client? 1 Hyperkalemia 2 Liver dysfunction 3 Orthostatic hypotension 4 Increased blood glucose

Take the oral hypoglycemic pill, drink warm fluids, and perform a serum glucose test before meals and at bedtime.

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse instruct the client to do? 1 Skip the oral hypoglycemic pill, drink plenty of fluids, and stay in bed. 2 Avoid food, drink clear liquids, take a daily temperature, and stay in bed. 3 Eat as much as possible, increase fluid intake, and call the office again the next day. 4 Take the oral hypoglycemic pill, drink warm fluids, and perform a serum glucose test before meals and at bedtime.

1 "Exercise increases the need for carbohydrates and decreases the need for insulin." Exercise increases the uptake of glucose by active muscle cells without the need for insulin; carbohydrates are needed to supply energy for the increased metabolic rate associated with exercise. The need for insulin is decreased.

A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? 1 "Exercise increases the need for carbohydrates and decreases the need for insulin." 2 "Exercise increases the need for insulin and increases the need for carbohydrates." 3 "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." 4 "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."

Aerobic exercise

A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? 1 Overeating 2 Intestinal virus 3 Aerobic exercise 4 Missed insulin dose

I will break in my new shoes over the course of several weeks."

A client with diabetes is given instructions about foot care. Which statement made by the client shows effective learning? 1 "I will trim my toenails before bathing." 2 "I will soak my feet daily for one hour." 3 "I will examine my feet using a mirror at least once a week." 4 "I will break in my new shoes over the course of several weeks."

Ask the client to ingest one tube of glucose gel 4-6 oz is 15 gm

A nurse is caring for an alert client with diabetes who is receiving an 1800-calorie diabetic diet. The client's blood glucose level is 30 mg/dL (3 mmol/L). The primary healthcare provider's protocol calls for treatment of hypoglycemia with 15 g of a simple carbohydrate. What should the nurse do first? 1 Provide 12 ounces (360 mL) of nondiet soda 2 Give 25 mL dextrose 50% by slow intravenous (IV) push 3 Have the client drink 8 ounces (240 mL) of fruit juice 4 Ask the client to ingest one tube of glucose gel

"Your glucose level will be hard to control as you reach term."

A client with poorly controlled type 1 diabetes is now in her thirty-fourth week of pregnancy. The primary healthcare provider tells her that she should have an amniocentesis at 37 weeks to assess fetal lung maturity and that induction of labor will be initiated if the fetus's lungs are mature. The client asks the nurse why an early birth may be necessary. How should the nurse reply? 1 "You'll be protected from developing hypertension." 2 "Your glucose level will be hard to control as you reach term." 3 "The baby will be small enough for you to have a vaginal birth." 4 "The chance that your baby will have hypoglycemia will be reduced."

Increased serum lipids With diabetic ketoacidosis, serum lipid levels are high because of the increased breakdown of fat. Serum lipid levels can go so high that the serum appears opalescent and creamy. With diabetic ketoacidosis the hematocrit level generally is increased because of dehydration. The calcium level is unrelated to diabetic ketoacidosis. With diabetic ketoacidosis the blood urea nitrogen level generally is increased because of dehydration.

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? 1 Increased serum lipids 2 Decreased hematocrit level 3 Increased serum calcium levels 4 Decreased blood urea nitrogen level

Remain elevated Emotional and physical stress may cause insulin requirements to remain elevated in the postoperative period. Insulin requirements will remain elevated rather than decrease. Fluctuating insulin requirements usually are associated with noncompliance, not surgery. A sharp increase in the client's insulin requirements may indicate sepsis, but this is not expected.

A client with type 1 diabetes is admitted to the hospital for major surgery. Before surgery, the client's insulin requirements are elevated but well controlled. What insulin requirements will the nurse anticipate for this client postoperatively? 1 Decrease 2 Fluctuate 3 Increase sharply 4 Remain elevated

1 Polyuria 2 Polydipsia 4 Respiratory rate of 26 breaths/min Glucose that is being filtered in the kidney acts as an osmotic diuretic; glycosuria promotes polyuria. Polydipsia (excessive thirst) and fluid intake are the responses to excess fluid loss related to osmotic diuresis. With hyperglycemia, there may be hyperventilation in an attempt to blow off carbon dioxide if ketones are produced; 26 breaths/min is characteristic of hyperventilation. Paralytic ileus is not associated with hyperglycemia. Serum glucose of 105 mg/dL (5.8 mmol/L), by most standards, is within the expected range of 60 to 110 mg/dL (3.3 to 6.1 mmol/L).

A nurse is caring for a client who is receiving total parenteral nutrition. Which responses indicate that the client is experiencing hyperglycemia? Select all that apply. 1 Polyuria 2 Polydipsia 3 Paralytic ileus 4 Respiratory rate of 26 breaths/min 5 Serum glucose of 105 mg/dL (5.8 mmol/L)

Blurry, spotty, or hazy vision Blurry, spotty, or hazy vision; floaters or cobwebs in the visual field; and cataracts or complete blindness can occur as a result of diabetes. Diabetic retinopathy is characterized by abnormal growth of new blood vessels in the retina (neovascularization). More than 60% of clients with type 2 diabetes have some degree of retinopathy after 20 years. Arthritic changes of the hands are not a usual complication associated with diabetes mellitus. Clients who are diabetic have peripheral neuropathy, which is characterized by hypoactive, not hyperactive, reflexes. Peripheral vascular disease is indicated by dependent rubor with pallor on elevation, not dependent pallor.

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes? 1 Blurry, spotty, or hazy vision 2 Arthritic changes in the hands 3 Hyperactive knee and ankle jerk reflexes 4 Dependent pallor of the feet and lower legs

Maintaining normoglycemia

A nurse is teaching a 15-year-old adolescent with newly diagnosed type 1 diabetes about self-care. What is the primary long-term goal this nurse and client should agree on? 1 Maintaining normoglycemia 2 Complying with the diabetic diet 3 Adhering to an exercise program 4 Developing a nonstressful lifestyle

Insulin pumps mimic the way a healthy pancreas works.

A nurse plans to teach a client with type 1 diabetes about the use of an insulin pump. What information will the nurse include in client teaching? 1 Insulin pumps mimic the way a healthy pancreas works. 2 The insulin pump's needle should be changed every day. 3 Pumps are implanted in a subcutaneous pocket near the abdomen. 4 The insulin pump's advantage is that it only requires glucose monitoring once a day.

Twenty-fourth and twenty-eighth weeks of gestation At the end of the second trimester and the beginning of the third trimester, insulin needs increase because of an increase in maternal resistance to insulin. During the earlier part of pregnancy, fetal demands for maternal glucose may cause a tendency toward hypoglycemia. During the last weeks of pregnancy, maternal resistance to insulin decreases, and insulin needs decrease accordingly.

A primigravida client with type 1 diabetes is attending her first prenatal visit. While discussing changes in insulin needs during pregnancy and after birth, the nurse explains that in light of the client's blood glucose readings she should expect to increase her insulin dosage. Between which weeks of gestation is this expected to occur? 1 Tenth and twelfth weeks of gestation 2 Eighteenth and twenty-second weeks of gestation 3 Twenty-fourth and twenty-eighth weeks of gestation 4 Thirty-sixth and fortieth weeks of gestation

"I need to stop taking my insulin when I am ill because I am not eating."

The nurse is assessing the client admitted with diabetic ketoacidosis. Which statement made by the client indicates a need for further education on sick day management? 1 "I need to stop taking my insulin when I am ill because I am not eating." 2 "I will check my urine for ketones when my blood sugar is over 250." 3 "I will try and take in Gatorade and water when I am sick." 4 "I will continue all my insulin including my glargine when I am sick."

70 to 105 mg/dL (3.9 to 5.8 mmol/L) of blood

The primary healthcare provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. What is the goal of treatment with glucose levels for this client? 1 40 to 65 mg/dL (2.2 to 3.6 mmol/L) of blood 2 70 to 105 mg/dL (3.9 to 5.8 mmol/L) of blood 3 110 to 145 mg/dL (6.1 to 8.0 mmol/L) of blood 4 150 to 175 mg/dL (8.3 to 9.7 mmol/L) of blood

Difficulty concentrating, hunger, and diaphoresis are the most common signs and symptoms of hypoglycemia. Increased adrenergic nervous system activity and increased catecholamine secretion produce hunger and diaphoresis. Difficulty concentrating reflects central nervous system glucose deprivation. Increased thirst, sleepiness, and nausea are signs and symptoms of hyperglycemia as ketoacidosis develops. Confusion, dry mouth, and diminished reflexes are signs and symptoms of hyperglycemia; they reflect ketoacidosis. Flushed face, deep breathing, and abdominal pain are signs and symptoms of ketoacidosis

Which clinical findings should cause the nurse to suspect that an adolescent child with type 1 diabetes is hypoglycemic? 1 Increased thirst, sleepiness, and nausea 2 Confusion, dry mouth, and diminished reflexes 3 Difficulty concentrating, hunger, and diaphoresis 4 Flushed face, deep breathing, and abdominal pain

3 Blood glucose level less than 40 mg/dL (2.2 mmol/L)

Which nursing assessment is most important for a large-for-gestational-age (LGA) infant of a diabetic mother (IDM)? 1 Temperature less than 98° F (36.6° C) 2 Heart rate of 110 beats/min 3 Blood glucose level less than 40 mg/dL (2.2 mmol/L) 4 Increasing bilirubin during the first 24 hours

"Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? 1 "I will need to have my eyes and vision examined once a year." 2 "I will need to check my blood sugar at home to evaluate my response to my treatment plan." 3 "I can improve metabolic and cardiac risk factors of this disease if I follow a low-calorie diet and lose weight." 4 "Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."

"No, the insulin will help your body handle the increased potassium level."

While the nurse is at the bedside of a client in acute renal failure, the client states, "My healthcare provider said that I will be getting some insulin. Do I also have diabetes?" What is the best nursing response? 1 "No, the insulin will help your body handle the increased potassium level." 2 "I suggest that you ask your healthcare provider that question." 3 "You probably had an elevated blood glucose level, so your healthcare provider is being cautious." 4 "No, but insulin will reduce the toxins in your blood by lowering your metabolic rate."

Offer a snack to prevent hypoglycemia during the night.

An 8-year-old child is being given insulin glargine before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack? 1 Offer a snack to prevent hypoglycemia during the night. 2 Give the child a snack if signs of hyperglycemia are present. 3 Avoid a snack because the child is being treated with long-acting insulin. 4 Keep a snack at the bedside in case the child gets hungry during the night.

"I will stop taking metformin for 24 hours before and after having a test involving dye."

A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? 1 "I will take the drug with food." 2 "I must swallow my medication whole and not crush or chew it." 3 "I will notify my doctor if I develop muscular or abdominal discomfort." 4 "I will stop taking metformin for 24 hours before and after having a test involving dye."

Stimulates the pancreas to produce insulin

A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide? 1 Stimulates the pancreas to produce insulin 2 Accelerates the liver's release of stored glycogen 3 Increases glucose transport across the cell membrane 4 Lowers blood glucose in the absence of pancreatic function

Upper respiratory infection

A client with type 1 diabetes who has been adhering to a prescribed insulin regimen is admitted to the hospital in ketoacidosis. Which factor may have precipitated the ketoacidosis? 1 Increased exercise 2 Decreased food intake 3 Working the night shift 4 Upper respiratory infection

"Do not take an extra pill because you may become hypoglycemic when exercising."

A client with type 2 diabetes is taking one glyburide tablet daily. The client asks whether an extra pill should be taken before exercise. What is the nurse's best reply? 1 "You will need to decrease how much you are exercising." 2 "An extra pill will help your body use glucose when exercising." 3 "The amount of medication you need to take is not related to exercising." 4 "Do not take an extra pill because you may become hypoglycemic when exercising."

Hyperpnea Rapid breathing is an attempt by the respiratory system to eliminate excess carbon dioxide; it is a characteristic compensatory mechanism for correcting metabolic acidosis. An increase in temperature will occur if an infection is present; it is not a response to hyperglycemia. Tachycardia, not bradycardia, results from the hypovolemia of dehydration. Hypotension, not hypertension, may result from the decreased vascular volume associated with hyperglycemia.

An unconscious 16-year-old adolescent with type 1 diabetes is brought to the emergency department. The blood glucose level is 742 mg/dL (41.2 mmol/L). What finding does the nurse expect during the initial assessment? 1 Pyrexia 2 Hyperpnea 3 Bradycardia 4 Hypertension

Perform a finger stick to test the client's blood glucose level.

A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action? 1 Have the client assessed for an enlarged prostate. 2 Obtain a urine specimen from the client to test for ketonuria. 3 Perform a finger stick to test the client's blood glucose level. 4 Assess the client's lower extremities for the presence of pitting edema.

Feeding the infant

A newborn experiences a hypothermic period while being bathed and having clothing changed. Once the hypothermic episode has been identified and treated, what is the next nursing action? 1 Feeding the infant 2 Requesting a complete blood count 3 Monitoring the infant for hyperthermia 4 Allowing the infant to rest undisturbed

2 Monitoring the infant's blood glucose level

A newborn is admitted to the nursery and classified as small for gestational age (SGA). What is the priority nursing intervention for this infant? 1 Testing the infant's stools for occult blood 2 Monitoring the infant's blood glucose level 3 Placing the infant in the Trendelenburg position 4 Comparing the infant's head circumference and chest circumference

Hyperglycemia

After a surgical procedure for cancer of the pancreas with removal of the stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, what symptom exhibited by the client requires immediate attention by the nurse? 1 Jaundice 2 Indigestion 3 Weight loss 4 Hyperglycemia

Calcium gluconate

After a surgical thyroidectomy a client exhibits carpopedal spasm and some tremors. The client complains of tingling in the fingers and around the mouth. What medication should the nurse expect the primary health care provider to prescribe after being notified of the client's adaptations? 1 Potassium iodide 2 Calcium gluconate 3 Magnesium sulfate 4 Potassium Chloride

Liver disease Liver stores glycogen, disease=not used

In addition to clients who are receiving insulin for type 1 diabetes, the nurse should assess for signs and symptoms of hypoglycemia in clients who have which diagnosis? 1 Liver disease 2 Type 2 diabetes 3 Hyperthyroidism 4 Stage 3 hypertension

Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.

The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan? 1 Oral hypoglycemics work by decreasing absorption of carbohydrates. 2 Oral hypoglycemics work by stimulating the pancreas to produce insulin. 3 Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. 4 Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral hypoglycemics.

The client should obtain a finger stick blood sugar reading before each meal. The teaching plan should include signs and symptoms of hypoglycemia. The teaching plan should include sick day rules.

The nurse is educating the client newly diagnosed with type 2 diabetes on oral antidiabetic medications. What should the nurse include in the teaching plan? Select all that apply. 1 The client should obtain a finger stick blood sugar reading before each meal. 2 The client does not need to follow a specific diet until insulin is required. 3 The teaching plan should include signs and symptoms of hypoglycemia. 4 The teaching plan does not need to include signs and symptoms of hypoglycemia, as the client is not on insulin. 5 The teaching plan should include sick day rules.

Confusion, Excessive thirst, Fruity-scented breath

The nurse is providing teaching to a client who recently has been diagnosed with type 1 diabetes. The nurse reinforces the importance of monitoring for ketoacidosis. What are the signs and symptoms of ketoacidosis? Select all that apply. 1 Confusion 2 Hyperactivity 3 Excessive thirst 4 Fruity-scented breath 5 Decreased urinary output

"Do not ingest anything before the test."

A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information? 1 "Eat your usual breakfast." 2 "Have clear liquids for breakfast." 3 "Take your medication before the test." 4 "Do not ingest anything before the test."

Gradually decrease the rate. prevents hypoglycemia

A newborn whose mother has type 1 diabetes has been receiving a continuous infusion of fluids with glucose. What should the nurse do when there is a prescription to discontinue the infusion? 1 Gradually decrease the rate. 2 Observe for metabolic alkalosis. 3 Withhold oral feedings for several hours. 4 check bs every hour

1 "I am 55 years old." 2 "I quite often feel thirsty." 3 "I eat food every 2 hours."

After assessing a client's condition, the nurse suspects that the client has diabetes mellitus. Which statement made by the client would be most appropriate in helping the nurse reach this conclusion? Select all that apply. 1 "I am 55 years old." 2 "I quite often feel thirsty." 3 "I eat food every 2 hours." 4 "I have excessive sweating." 5 "I sometimes experience shortness of breath."

Before lunch

Daily regular insulin has been prescribed for a client with type 1 diabetes. The nurse administers the insulin at 8 am. When should the nurse monitor the client for a potential hypoglycemic reaction? 1 At breakfast 2 Before lunch 3 Before dinner 4 In the early afternoon

3 Insulin-induced hypoglycemia

The health care provider prescribes one tube of glucose gel for the client with type 1 diabetes. The nurse recognizes that this is for treatment of which diabetes complication? 1 Diabetic acidosis 2 Hyperinsulin secretion 3 Insulin-induced hypoglycemia 4 Idiosyncratic reactions to insulin

Measure the blood glucose level between 2 AM and 4 AM. During the hours of sleep, the Somogyi effect may be caused by a decline in the blood glucose level in response to too much insulin. The resulting hypoglycemia stimulates counterregulatory hormones, which precipitate lipolysis, gluconeogenesis, and glycogenolysis, which in turn produce rebound hyperglycemia and ketosis. Treatment involves decreasing the evening insulin. The client should check blood glucose between 2 AM and 4 AM and if the blood glucose is less than 70, the client is having a Somogyi effect. The dawn phenomenon is characterized by the release of counterregulatory hormones in the predawn hours, precipitating hyperglycemia on awakening. Treatment involves an increase in insulin. Eating a snack before going to bed should be done when insulin is taken before sleep, but it will not help to differentiate between the Somogyi effect and the dawn phenomenon. Administering the prescribed bedtime insulin immediately before going to bed depends on the insulin regimen prescribed by the health care provider and will not help to differentiate between the Somogyi effect and the dawn phenomenon. The manifestation (symptoms) of hyperglycemia has no role in differentiating the conditions.

A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon? 1 Eat a snack before going to bed. 2 Measure the blood glucose level between 2 AM and 4 AM. 3 Identify whether morning symptoms are typical for hyperglycemia. 4 Administer the prescribed bedtime insulin immediately before going to bed.

"Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mothers during pregnancy, so the glucose level may drop."

A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How should the nurse best respond? 1 "A newborn's glucose level drops after birth, so we're being especially cautious with your baby because of your diabetes." 2 "A newborn's pancreas produces an increased amount of insulin during the first day of birth, so we're checking to see whether hypoglycemia has occurred." 3 "Babies of mothers with diabetes do not have large stores of glucose at birth, so it's difficult for them to maintain the blood glucose level within an acceptable range." 4 "Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mothers during pregnancy, so the glucose level may drop."

Regular insulin

The nurse is caring for a client with diabetes mellitus who is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. What does the nurse recognize as the only type of insulin that is compatible with intravenous solutions? 1 NPH insulin 2 Insulin lispro 3 Regular insulin 4 Insulin glargine

Insulin needs will increase during the second trimester.

The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information should the nurse give to this client? 1 Insulin needs will increase during the second trimester. 2 Insulin needs will decrease during the second trimester. 3 Insulin needs will not change during the second trimester. 4 Insulin will be switched to an oral antidiabetic medication during the second trimester.

The blood glucose level will increase because of the stress of surgery. Diabetic control is usually maintained with insulin after surgery. The stress of surgery causes the release of epinephrine and glucocorticoids, which increase the blood glucose level. Most individuals with type 2 diabetes who control their diabetes through diet and exercise require insulin during the recovery period. Although the child with diabetes is at risk for infection, surgical aseptic technique should prevent infection. Ketoacidosis is associated with type 1, not type 2, diabetes. Urine test results are affected by many variables and therefore are not reliable indicators of the blood glucose level.

A 12-year-old child with type 2 diabetes is scheduled for abdominal surgery. Which factors are most important for the nurse to consider during the postoperative period? Select all that apply. 1 Infection will likely occur at the surgical site. 2 Ketoacidosis frequently occurs later in the postoperative period. 3 The blood glucose level will increase because of the stress of surgery. 4 Urine test results are the most useful gauge of diabetic control after surgery. 5 Diabetic control is usually maintained with insulin after surgery.

Glucocorticoids accelerate the process of gluconeogenesis.

A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus? 1 Cortical hormones stimulate rapid weight loss. 2 Tissue catabolism results in a negative nitrogen balance. 3 Glucocorticoids accelerate the process of gluconeogenesis. 4 Excessive adrenocorticotropic hormone (ACTH) secretion damages pancreatic tissue.