When caring for a patient post-surgical removal of the pancreas, which complication should the nurse prioritize monitoring?

Choice A reason: While postoperative bleeding is a risk for any major abdominal surgery, it is not a complication specific to the loss of pancreatic function itself. Standard surgical monitoring covers this, but the unique physiological consequence of removing the entire organ is the absolute loss of endocrine hormone production. Choice B reason: Hypocalcemia is often a concern in acute pancreatitis due to fat necrosis and soap formation, or in parathyroid surgery. It is not a primary expected complication of a pancreatectomy. Parathyroid function is unrelated to the pancreas, so parathyroid insufficiency would not occur as a result of this procedure. Choice C reason: Hypovolemia and fluid shifts occur during the acute phase of surgery and recovery, but these are managed via standard intensive care protocols. They do not represent the long-term, life-altering priority that occurs when the endocrine function of the pancreas is permanently and completely removed. Choice D reason: The pancreas contains the Islets of Langerhans, which produce insulin and glucagon. Complete removal of the pancreas (total pancreatectomy) results in immediate, permanent "brittle" diabetes mellitus. Monitoring blood glucose levels is the highest priority to manage hyperglycemia and prevent life-threatening diabetic ketoacidosis in these patients.