Page 1411 - Saunders Comprehensive Review For NCLEX-RN

g. Weakness or loss of sensation in cranial
nerves III (oculomotor), IV (trochlear),
V (trigeminal), and VI (abducens)
h. Dizziness and postural hypotension
i. Nausea and vomiting
j. Diarrhea or constipation
k. Incontinence
l. Dyspareunia
m. Impotence
n. Hypoglycemic unawareness
4. Interventions
a. Early prevention measures include the
control of hypertension and blood
glucose levels.
b. Careful foot care is required to prevent
trauma (Box 46-17).
c. Administer medications as prescribed
for pain relief.
d. Initiate bladder training programs.
e. Instruct in the use of estrogen-
containing lubricants for women with
dyspareunia.
f. Prepare the male client with impotence
for penile injections or other possible
treatment options as prescribed.
g. Prepare for surgical decompression of
compression lesions related to the
cranial nerves as prescribed.

X. Care of the Diabetic Client Undergoing Surgery

A. Preoperative care
1. Check with PHCP regarding withholding oral
hypoglycemic medications or insulin.
2. Some long-acting oral antidiabetic medications are
discontinued 24 to 48 hours before surgery.
3. Metformin may need to be discontinued 48 hours
before surgery and may not be restarted until renal
function is normal postoperatively.
4. All other oral antidiabetic medications are usually
withheld on the day of surgery.
5. Insulin dose may be adjusted or withheld if IV insulin
administration during surgery is planned.
6. Monitor blood glucose level.
7. Administer IV fluids as prescribed.
B. Postoperative care
1. Administer IV glucose and insulin infusions as
prescribed until the client can tolerate oral feedings.
2. Administer supplemental short-acting insulin as

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