A hospitalized patient with diabetes tells the nurse, I don't ...

[haleyc112]

A hospitalized patient with diabetes tells the nurse, I don't understand why I can keep my blood sugar under control at home with diet alone, but when I get sick, my blood sugar goes up. This is so frustrating.
 
  Which response by the nurse is most appropriate?
  a. It is probably just coincidental that your blood glucose is higher when you are ill.
  b. Stressors such as illness cause the release of hormones that increase blood glucose.
  c. Increased blood glucose occurs because the liver is not able to metabolize glucose as well during stressful times.
  d. Your diet is different here in the hospital than at home and that is the most likely cause of the increased glucose level.

Question 2

A middle-aged male patient with usually well-controlled hypertension and diabetes visits the clinic. Today he has a blood pressure of 174/94 and a blood glucose level of 190 mg/dL.
 
  What additional patient information may indicate that an intervention by the nurse is needed?
  a. The patient indicates that he usually does blood glucose monitoring several times each day.
  b. The patient states that he usually takes his prescribed antihypertensive medications on a daily basis.
  c. The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son.
  d. The patient states that the results are related to his family history because both of his parents have high blood pressure and diabetes.

[ciecieme]

Answer to Question 1

ANS: B
The release of cortisol, epinephrine, and norepinephrine increase blood glucose levels. The increase in blood glucose is not coincidental. The liver does not control blood glucose. A diabetic patient who is hospitalized will be on an appropriate diet to help control blood glucose.

Answer to Question 2

ANS: C
The increase in blood pressure and glucose levels possibly suggests that stress caused by his divorce and custody battle may be adversely affecting his health. The nurse should assess this further and develop an appropriate plan to assist the patient in decreasing his stress. Although he has been very compliant with his treatment plan in the past, the nurse should assess whether the stress in his life is interfering with his management of his health problems. The family history will not necessarily explain why he has had changes in his blood pressure and glucose levels.

[haleyc112]

Thanks for the timely response, appreciate it

[phuda]

TYSM