JOHN TYLER COMMUNITY COLLEGE NSG 170 TEST
3 – METABOLISM QUESTIONS WITH COMPLETE
SOLUTIONS
Enhancing Surgical Recovery
Surgical interventions for DM include:
A pancreas transplantation or islet cell transplantation
When successful, these procedures eliminate the need for insulin
injections, blood glucose monitoring, and many dietary
restrictions
Pancreatic transplant is successful when the patient no longer
needs insulin therapy and all blood measures of glucose are
normal
The patient with DM undergoing a surgical procedure is
expected to recover completely without complications.
Indicators include:
• Wound healing
• Absence of infection
• Maintenance of blood glucose levels within expected range
Anesthesia and surgery cause a stress response with release of:
,Counterregulatory hormones that elevate blood glucose
Stress hormones suppress insulin action, increasing the risk for:
Ketoacidosis acidosis
Hyperglycemic-hyperosmolar state (HHS) is:
A serious complication after surgery and is associated with
increased mortality
Autonomic neuropathy may result in:
Sudden tachycardia, bradycardia, or postural hypotension
Preoperative blood glucose levels should be less than:
200 mg/dL (11.1 mmol/L)
Higher levels are associated with increased infection rates and
impaired wound healing
Pain, a stressor, triggers the release of counterregulatory
hormones, increasing:
Blood glucose levels and insulin needs
Patients with autonomic neuropathy or vascular disease need
close monitoring to avoid:
Hypotension or respiratory arrest
Those who take beta blockers for hypertension need close
monitoring for hypoglycemia because:
These drugs mask symptoms of hypoglycemia
,Patients with increased blood protein or nitrogens in the blood
may have problems with:
Fluid management
Glucose levels are a sensitive marker of counterregulatory
hormones, which are often activated before patients become:
Febrile
Hyperglycemia often occurs before a fever
When a patient who has had reasonably controlled blood
glucose levels in the hospital develops an unexpected rise in
blood glucose values, check for:
Wound infection
Hyperkalemia (high blood potassium level) is common in
patients with mild to moderate kidney failure and can lead to:
Cardiac dysrhythmia
In other patients, hypokalemia (low blood potassium level) may
occur and be made worse by:
Insulin and glucose given during surgery
Patients with DM are at higher risk for what after surgery?
MI with a higher mortality risk
What may indicate a silent MI?
Changes in ECG or potassium levels
Patients requiring clear or full liquid diets should receive:
, About 200 g of carbohydrate daily in equally divided amounts at
meals and snack times
Initial liquids should not be sugar free
How many calories per kilogram of body weight do most
patients require every 24 hours?
25 to 35 calories per kilogram of body weight every 24 hours
If TPN is used after surgery, what may occur?
Severe hyperglycemia
Preventing Injury from Peripheral Neuropathy
The patient with DM is expected to identify factors that increase
the risk for injury, practice proper foot care, and maintain intact
skin on the feet. Indicators include that the patient consistently
demonstrates these behaviors:
• Cleanses and inspects the feet daily
• Wears properly fitting shoes
• Avoids walking in bare feet
• Trims toenails properly
• Reports nonhealing breaks in the skin of the feet to the primary
health care provider
Patients with DM need intensive teaching about foot care
because foot injury is a common complication. Once a failure of
3 – METABOLISM QUESTIONS WITH COMPLETE
SOLUTIONS
Enhancing Surgical Recovery
Surgical interventions for DM include:
A pancreas transplantation or islet cell transplantation
When successful, these procedures eliminate the need for insulin
injections, blood glucose monitoring, and many dietary
restrictions
Pancreatic transplant is successful when the patient no longer
needs insulin therapy and all blood measures of glucose are
normal
The patient with DM undergoing a surgical procedure is
expected to recover completely without complications.
Indicators include:
• Wound healing
• Absence of infection
• Maintenance of blood glucose levels within expected range
Anesthesia and surgery cause a stress response with release of:
,Counterregulatory hormones that elevate blood glucose
Stress hormones suppress insulin action, increasing the risk for:
Ketoacidosis acidosis
Hyperglycemic-hyperosmolar state (HHS) is:
A serious complication after surgery and is associated with
increased mortality
Autonomic neuropathy may result in:
Sudden tachycardia, bradycardia, or postural hypotension
Preoperative blood glucose levels should be less than:
200 mg/dL (11.1 mmol/L)
Higher levels are associated with increased infection rates and
impaired wound healing
Pain, a stressor, triggers the release of counterregulatory
hormones, increasing:
Blood glucose levels and insulin needs
Patients with autonomic neuropathy or vascular disease need
close monitoring to avoid:
Hypotension or respiratory arrest
Those who take beta blockers for hypertension need close
monitoring for hypoglycemia because:
These drugs mask symptoms of hypoglycemia
,Patients with increased blood protein or nitrogens in the blood
may have problems with:
Fluid management
Glucose levels are a sensitive marker of counterregulatory
hormones, which are often activated before patients become:
Febrile
Hyperglycemia often occurs before a fever
When a patient who has had reasonably controlled blood
glucose levels in the hospital develops an unexpected rise in
blood glucose values, check for:
Wound infection
Hyperkalemia (high blood potassium level) is common in
patients with mild to moderate kidney failure and can lead to:
Cardiac dysrhythmia
In other patients, hypokalemia (low blood potassium level) may
occur and be made worse by:
Insulin and glucose given during surgery
Patients with DM are at higher risk for what after surgery?
MI with a higher mortality risk
What may indicate a silent MI?
Changes in ECG or potassium levels
Patients requiring clear or full liquid diets should receive:
, About 200 g of carbohydrate daily in equally divided amounts at
meals and snack times
Initial liquids should not be sugar free
How many calories per kilogram of body weight do most
patients require every 24 hours?
25 to 35 calories per kilogram of body weight every 24 hours
If TPN is used after surgery, what may occur?
Severe hyperglycemia
Preventing Injury from Peripheral Neuropathy
The patient with DM is expected to identify factors that increase
the risk for injury, practice proper foot care, and maintain intact
skin on the feet. Indicators include that the patient consistently
demonstrates these behaviors:
• Cleanses and inspects the feet daily
• Wears properly fitting shoes
• Avoids walking in bare feet
• Trims toenails properly
• Reports nonhealing breaks in the skin of the feet to the primary
health care provider
Patients with DM need intensive teaching about foot care
because foot injury is a common complication. Once a failure of
