Free NCLEX Practice Questions.
Take Practice Question # 422.
Nclex Practice Questions.
CARE OF THE DIABETIC CLIENT UNDERGOING SURGERY
Preoperative care
- Check with physician regarding withholding oral hypoglycemic medications or insulin.
- Some long-acting oral antidiabetic medications are discontinued 24 to 48 hours before surgery.
- Metformin (Glucophage)may need to be discontinued 48 hours before surgery andmaynot be restarted until renal function is normal postoperatively.
- All other oral antidiabetic medications are usually withheld the day of surgery.
- Insulin dose may be adjusted or withheld if IV insulin administration during surgery is planned.
- Monitor blood glucose level.
- Administer IV fluids as prescribed.
Intraoperative care
- Monitor blood glucose levels frequently.
- Administer IV short- or rapid-acting insulin as prescribed to maintain the blood glucose level lower than 200 mg/dL.
Postoperative care
- Administer IV glucose and regular insulin infusions as prescribed until the client can tolerate oral feedings.
- Administer supplemental short-acting insulin as prescribed based on blood glucose results.
- Monitor blood glucose levels frequently if the client is receiving parenteral nutrition.
- When the client is tolerating food, ensure that the client receives an adequate amount of carbohydrates daily to prevent hypoglycemia.
- Client is at higher risk for cardiovascular and renal complications postoperatively.
- Client is also at risk for impaired wound healing.
