**Complex Concept I Exam 2: Metabolism Part 2

Cushing's Management of Care:

-I&O, daily weight -Assess for hypervolemia- edema, distended neck veins, SOB, hypertension, tachycardia -Maintain safe environment to minimize pathological fractures & skin trauma -Prevent infections w/handwashing -Physical activity within limits -Meticulous skin care -Change position every 2 hours -Monitor/protect against skin breakdown & infection -Surgical asepsis when performing dressing changes & invasive procedures. -Monitor WBC count with differential daily

Complications of hypothyroidism:

-MYXEDEMA COMA -hypothermia -decreased VS and LOC -respiratory failure -death

A 68-year-old woman, recently diagnosed with osteoporosis, is initiated on a therapeutic regimen that includes alendronate (Fosamax). The nurse, familiar with the specific administration guidelines and potential side effects of this medication, prepares to provide the patient with essential instructions and monitoring. Which of the following nursing interventions is pivotal when administering alendronate to this patient? A. Administer the medication with a full glass of water on an empty stomach. B. Encourage the patient to lie flat for 30 minutes after taking the medication. C. Monitor for signs of hypercalcemia. D. Instruct the patient to take the medication with calcium-rich foods.

A

Nurse Zeny is caring for a client in an acute Addisonian crisis. Which laboratory data would the nurse expect to find? A. Hyperkalemia B. Reduced blood urea nitrogen (BUN) C. Hypernatremia D. Hyperglycemia

A

Teaching clients in a senior center about risk factors for osteoporosis. Which statement should the nurse include in the teaching? A. Extended periods of immobility increase your risk of osteoporosis B. Prolonged periods of sun exposure increases your risk C. Eating a diet high in protein can reduce your risk D. Corticosteroids can reduce your risk

A

The nurse teaches a client recently diagnosed with hyperthyroidism. The nurse encourages which lifestyle recommendation? A. "Establish a relaxing bedtime routine." B. "Maintain a calorie-restricted diet plan." C. "Incorporate iodine-rich foods into your diet." D. "Include vigorous exercise in your daily routine."

A

The nurse teaches a client with hypothyroidism about diet and nutrition. The nurse encourages the client to follow which recommendation? A. The client should consume 25-30 grams of fiber daily. B. The client should limit intake of dark, leafy green vegetables. C. The client should peel the skins off of fruits and vegetables. D. The client should keep sodium intake at 1,500 mg per day or less.

A

Nursing interventions appropriate for a patient with Cushing's syndrome include: A. Monitoring fluid intake and output. B. Administering foods rich in sodium. C. Stopping corticosteroid intake once symptoms have diminished D. All of the above The nurse assesses a client with Cushing syndrome. Which assessment finding does the nurse recognize as consistent with Cushing disease? A. The client has clear, smooth, pale skin. B. The client's blood pressure is 82/57 mmHg. C. The client has excess fat deposits on the face. D. The client's fasting serum glucose is 72 mg/dL (4.0 mmol/L).

A C

A 74-year-old woman with a history of multiple vertebral compression fractures is admitted to the rehabilitation unit. She has been diagnosed with advanced osteoporosis. The interdisciplinary team gathers to discuss her management plan. The nurse, considering the most effective interventions to slow the progression of the patient's osteoporosis and reduce the risk of future fractures, suggests several approaches. Which of the following interventions would be appropriate recommendations for this patient? Select all that apply. A. Advocating for a regimen of regular weight-bearing exercises tailored to her physical capabilities. B. Advising a dietary plan that significantly restricts calcium intake. C. Strongly recommending confinement to bed to minimize the risk of potential fractures. D. Prioritizing the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) as the primary treatment. E. Ensuring adequate dietary or supplemental calcium and vitamin D intake. F. Evaluating the home environment for fall risks and making necessary modifications. G. Recommending the use of bisphosphonates after consulting with her physician.

A ,E ,F ,G

The nurse teaches a client about taking over-the-counter supplements for osteoporosis. The nurse includes which information? Select All That Apply A. "Avoid taking calcium supplements with prescribed medications." B. "Take calcium supplements in divided daily doses with meals." C. "Take calcium supplements separately from vitamin D supplements." D. "Take calcium supplements with six to eight ounces of water." E. "Avoid eating citrus fruits when taking calcium supplements."

A, B, D

A nurse performs an admission assessment on a client with Cushing syndrome. Which manifestation does the nurse teach the student nurse to assess for?Select All That Apply A. bruising B. infection C. hypoglycemia D. muscle weakness E. hypertension

A, B, D, E

The nurse cares for a client admitted with thyroid storm. Which symptom is likely upon assessment? Select All That Apply A. The client's heart rate is 108 beats/min. B. The client reports frequent constipation. C. The client displays tremors in the hands bilaterally. D. The client's temperature is 103 °F (39.4 °C). E. The client's blood pressure is 122/89 mmHg

A, C, D

In a community healthcare center, the nurse is preparing to host a seminar on osteoporosis management for a diverse group of patients. Among the attendees are a 60-year-old professional dancer recently diagnosed with osteoporosis, a 75-year-old gentleman who has been managing osteoporosis for a decade, and a 68-year-old woman expressing concerns about the recent discontinuation of her hormone replacement therapy. Given the varied experiences and backgrounds of the patients, the nurse must carefully consider the content of the educational session. Which interventions should the nurse include in the teaching? Select all that apply. A. Encouraging regular weight-bearing exercises B. Advising against the use of assistive devices C. Promoting adequate calcium and vitamin D intake D. Instructing on fall prevention strategies E. Discussing the benefits of hormone replacement therapy

A, C, D, E

A nurse is determining a client's risk of developing osteoporosis. The nurse should identify which of the following as risk factors for bone loss? SATA A. Small body frame B. Hypertension C. African-American ethnicity D. Low vit D intake E. Smoking A nurse is reviewing a female client's medical record. Which finding does the nurse identify as a risk factor for osteoporosis? A. Decreased intake of phosphate containing food B. Spending several hours in the sun C. Increased estrogen levels D. History of anorexia nervosa.

A, D, E D

A nurse cares for a client with newly diagnosed hypothyroidism. Which physical characteristics does the nurse assess? Select All That Apply A. The client has abdominal distention. B. The client displays exophthalmos. C. The client has cool, dry skin. D. The client has slurred speech. E. The client reports heart palpitations. A clinical manifestation usually associated with hypothyroidism is: A. A pulse rate lower than 95 bpm but greater than 60 bpm. B. An elevated systolic blood pressure. C. Muscular fatigability. D. Weight loss.

A,C,D C

Osteoporosis Risk Factors (ACCESS)

A-lcohol Use C-orticosteroid Use C-alcium low E-strogen low S-moking S-edentary lifestyle/s ACCESS leads to OSTEOPOROSIS Female gender Family history Thin/lean body build are precursors to low bone density Over age 60 European Americans and Asians Endocrine disorders - hyperthyroidism, hyperparathyroidism, cushings, diabetes Acidosis - from high protein diet - (Ca may be withdrawn from bone as kidneys attempt to buffer excess acid, or acidosis may directly stimulate osteoclast function) Use of aluminum containing antacids, anticonvulsants, and heparin therapies - secondary

A nurse cares for a client with new onset hyperthyroidism. Which intervention does the nurse plan for this client? A. Offer the client cold soda or cola. B. Provide a cool and calm environment. C. Administer polyethylene glycol 3350 (MiraLAX) as prescribed. D. Suggest propylthiouracil or carbimazole.

B

Nurse Sugar is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? A. Pitting edema of the legs B. An irregular apical pulse C. Dry mucous membranes D. Frequent urination

B

Nurse Troy is aware that the most appropriate nursing diagnosis for a patient with Addison's disease is which of the following? A. Excessive fluid volume B. Risk for infection C. Urinary retention D. Hypothermia

B

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? A. Increased appetite and weight loss B. Puffiness of the face and hands C. Nervousness and tremors D. Thyroid gland swelling A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision

B C

Client with osteoporosis is being prescribed alendronate sodium. Which instruction for this medication will be included in the teaching? A. This med can be given IV once yearly B. Take it with a full glass of water on a empty stomach C. Side effects includes leukopenia D. It should be taken with Calcium containing foods to increase absorption. Which patient should not be prescribed alendronate (Fosamax) for osteoporosis? A. A female patient being treated for high blood pressure with an ACE inhibitor. B. A patient who is allergic to iodine/shellfish. C. A patient on a calorie restricted diet. D. A patient on bed rest who must maintain a supine position.

B D

Which of the following potentially serious complications could occur with therapy for hypothyroidism? A. Acute hemolytic reaction B. Angina or cardiac arrhythmia C. Retinopathy D. Thrombocytopenia Client with hypothyroidism. What manifestation does the nurse expect? Constipation Insomnia Tachycardia Diaphoresis

B constipation

A nurse assesses a client with hyperthyroidism. Which symptom of hyperthyroidism might be evident in the assessment? Select All That Apply A. The client displays unilateral lower extremity edema. B. The client displays tremors of the hands. C. The client reports episodes of photophobia. D. The client reports progressive weight gain. E. The client reports an increased appetite.

B, C, D

The nurse cares for a client with myxedema coma. Which sign or symptom is the nurse likely to observe in this client? The client's blood pressure is 78/52 mmHg. The client's serum glucose level is 95 mg/dL (5.3 mmol/L) The client's body temperature is 104 °F (40 °C). The client's serum sodium is 148 mEq/L (reference range 135-145 mEq/L).

B/P

A 71-year-old woman with a history of recurrent fractures presents to the rheumatology clinic. Radiographic studies and bone mineral density tests confirm a diagnosis of advanced osteoporosis. The rheumatologist, considering the most effective pharmacological intervention to decelerate the progression of her bone deterioration, contemplates prescribing a specific class of medication. Which of the following medications is frequently recommended as a primary therapeutic agent for the management of osteoporosis? A. Agents primarily designed to supplement calcium levels. B. Nonsteroidal anti-inflammatory drugs (NSAIDs) typically used for pain and inflammation. C. Bisphosphonates, known for their role in inhibiting bone resorption. D. Anticoagulants, commonly used to prevent blood clot formation.

C

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: A. Thyroid storm. B. Cretinism. C. Myxedema coma. D. Hashimoto's thyroiditis

C

Ruby is receiving thyroid replacement therapy, develops the flu and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication will put the client at risk for developing which of the following life threatening complications? A. Exophthalmos B. Thyroid storm C. Myxedema coma D. Tibial myxedema

C

The nurse cares for a client with Addison disease. Which assessment finding is likely to be identified with this client? A. The client has elevated serum sodium. B. The client displays truncal obesity. C. The client's fasting glucose is 60 mg/dL (3.3 mmol/L). D. The client's blood pressure is 154/90 mmHg.

C

The nurse teaches a client with newly diagnosed hyperthyroidism. The nurse instructs the client to seek immediate medical care for which symptom? A. The client develops restlessness and insomnia. B. The client develops eye swelling and photophobia. C. The client develops fever and palpitations. D. The client develops increased stools and diarrhea.

C

A 70-year-old woman is admitted to the orthopedic ward following a minor fall at home that resulted in a fractured wrist. Her medical history reveals a recent diagnosis of osteoporosis. As the nurse conducts a comprehensive assessment, she anticipates certain clinical manifestations commonly associated with osteoporosis. Which of the following findings would the nurse most likely expect to observe in this patient? A. Joint deformities B. Muscle atrophy C. Decreased bone density D. Increased range of motion Nurse Michelle is caring for an elderly female with osteoporosis. When teaching the client, the nurse should include information about which major complication: A. Bone fracture B. Loss of estrogen C. Negative calcium balance D. Dowager's hump

C A

When caring for a female client who is being treated for hyperthyroidism, it is important to: A. Provide extra blankets and clothing to keep the client warm. B. Monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. C. Balance the client's periods of activity and rest. D. Encourage the client to be active to prevent constipation. A 25-year-old client with Grave's disease is admitted to the unit. What would the nurse expect the admitting assessment to reveal? A. Bradycardia B. Decreased appetite C. Exophthalmos D. Weight gain

C C

A 78-year-old woman visits the clinic for a routine check-up. She expresses concern about her bone health, as several of her friends have been diagnosed with fractures due to osteoporosis. The physician explains that certain population groups are at a higher risk for developing this condition. Which of the following population groups is at the highest risk for developing osteoporosis? A. Young children B. Teenagers C. Postmenopausal women D. Middle-aged men The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to: A. Lack of exercise B. Hormonal disturbances C. Lack of calcium D. Genetic predisposition

C B

Nurse Cecile is teaching a female client about preventing osteoporosis. Which of the following teaching points is correct? A. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. B. To avoid fractures, the client should avoid strenuous exercise. C. The recommended daily allowance of calcium may be found in a wide variety of foods D. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement. Cleo is diagnosed with osteoporosis. Which electrolytes are involved in the development of this disorder? A. Calcium and sodium B. Calcium and phosphorous C. Phosphorus and potassium D. Potassium and sodium

C B

A 66-year-old postmenopausal woman is seen in the outpatient nutrition clinic for dietary counseling. She was recently diagnosed with osteoporosis after a bone density scan revealed significant reductions in her bone mineral density. The dietician, aiming to address the nutritional aspects of her condition, suggests a specific dietary modification to potentially mitigate the progression of her bone loss. Which of the following dietary adjustments would be most appropriate for this patient's condition? A. Imposing strict restrictions on her daily fluid consumption. B. Significantly reducing her protein consumption. C. Completely excluding carbohydrates from her meals. D. Augmenting her daily dietary regimen with calcium-rich foods or supplements.

D

A 76-year-old woman, newly diagnosed with osteoporosis, is preparing for discharge after a week-long hospital stay due to a minor fracture. As the nurse reviews home safety measures, the patient expresses concern about preventing future fractures in her home environment. She inquires, "Given my condition, what specific precautions should I adopt to ensure my safety at home?" Which of the following recommendations by the nurse would be most pertinent to address her concerns? A. "It's best to abstain entirely from any form of physical activity or exercise to minimize strain on your bones." B. "When attempting to access items from elevated areas, always utilize a robust step stool to ensure stability." C. "To foster a serene ambiance at home, it's advisable to maintain dim lighting throughout your living spaces." D. "It's crucial to eliminate potential tripping hazards, such as throw rugs or clutter, to create clear pathways in your residence."

D

A nurse cares for a client with hypothyroidism. The nurse implements which intervention to provide comfort for the client? A. Maintain a cool temperature in the client's room. B. Encourage the client to eat a low-residue diet. C. Request anti-diarrhea medication from the healthcare provider. D. Encourage the client to apply lotion after bathing.

D

A patient with Cushing's disease asks the nurse to help him choose a meal for dinner later. Which of the following meals is the best option? A. Hamburger with french fries and apple slices. B. Pork chops in cream sauce with mashed potatoes and carrots. C. Mexican-style beef with guacamole and beans on the side. D. Roasted chicken with corn and green beans.

D

Nursing comfort measures for a patient with hypothyroidism should include: A. Encouraging frequent periods of rest throughout the day. B. Offering the patient additional blankets to help prevent chilling. C. Using a cleansing lotion instead of soap for the skin. D. All of the above.

D

The nurse admits a client with myxedema coma. The family reports the client quit taking all medications recently. The nurse recognizes myxedema coma is a result of stopping medications for which disorder? A. The client quit taking medication for adrenal insufficiency. B. The client quit taking medication for hyperparathyroidism. C. The client quit taking medication for hyperpituitarism. D. The client quit taking medication for hypothyroidism.

D

What is included in the Cushing's triad? A. Buffalo hump. B. Moonface. C. Truncal obesity. D. All of the above Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: A. Hypotension. B. Thick, coarse skin. C. Deposits of adipose tissue in the trunk and dorsocervical area. D. Weight gain in arms and legs.

D C

Clinical manifestations of Cushing's syndrome may be modified with a diet that is: A. High in protein. B. Low in carbohydrates. C. Low in sodium. D. All of the above. The nurse teaches a client with newly diagnosed Cushing disease about dietary recommendations. Which statement indicates further education is needed? "I will switch to decaffeinated coffee." "I will drink a glass of wine a day." "I will add fatty fish to my diet." "I will eat leafy, green vegetables."

D Drink a glass of wine a day

Nursing care for a patient with hypothyroidism includes assessing for clinical manifestations associated with hypothyroidism. A manifestation not consistent with her diagnosis is a: A. Change in her menstrual pattern. B. Pulse rate of 58 bpm. C. Temperature of 95.88 ºF. D. Weight loss of 10 lbs over a 2-week period. The principle objective of medical management for hypothyroidism is to: A. Irradiate the gland in an attempt to stimulate hormonal secretion. B. Replace the missing hormone. C. Remove the diseased gland. D. Withhold exogenous iodine to create a negative feedback response, which will force the gland to secrete hormones.

D B

Hypothyroidism clinical manifestations: T3&T4 low, TSH high

Early findings : Fatigue, lethargy, irritability Intolerance to cold Constipation Weight gain w/o increased caloric intake Pale skin Thin, brittle nails with aging, thick, brittle, and yellow Depression Hair thinning Joint and/or muscle pain Systemic edema Anemia Elevated TSH; low T3 & T4; low H&H (anemia) Late findings: Bradycardia hypotension, dysrhythmias Slow thought process and speech Hypoventilation, pleural effusion Thickening of the skin Thinning of hair on the eyebrows Dry, flaky skin Swelling in face, hands, and feet (myxedema, non pitting, mucinous edema) Life threatening; untreated hypothyroidism; result of acute illness or trauma - Decreased acuity of taste and smell - Hoarse, raspy speech - Abnormal menstrual periods (menorrhagia/amenorrhea) and decreased libido

Cushing's Nutrition:

High calcium & vitamin D, Potassium Increase Protein Decrease Sodium intake

Assessing a client with Addison's disease. Which finding is expected? Hypotension Weight gain Sugar craving Pale skin tone

Hypotension

Management of Care of Hyperthyroidism:

Minimize energy expenditure by assisting w/ activities as necessary & by encouraging alternate periods of activity w/ rest. Provide a calm environment Assess mental status & decision making ability - ensure safety Monitor nutrition - provide increased calories, protein, and other nutritional support Limit iodine (shellfish, iodized salt) I&Os and daily weights Reduce room temperature. Provide cool shower/sponge bath for comfort; change linens as needed Provide eye protection (patches, lubricant, tape) for client w/ exophthalmos Monitor vitals & hemodynamics for findings of HF Report temp increase of 1 degree or more to MD Monitor ECG for dysrhythmias Abrupt changes in behavior should subside w/ antithyroid therapy Avoid excessive palpation of thyroid gland

Management of Care for hypothyroidism

Monitor for cardiovascular changes (low bp, bradycardia, dysrhythmias) Assess mental status; orient periodically; provide safety measures Increase activity level gradually; provide frequent rest periods to avoid fatigue and decrease heart oxygen demands Apply antiembolism stockings and elevate legs to assist venous return Encourage cough and deep to prevent pulmonary complications Provide a low calorie, high bulk diet & encourage activity to prevent constipation and promote weight loss give cathartics and stool softeners as needed Avoid fiber laxatives - Give meticulous skin care - q2 repositioning; use alcohol free skin products and emollient lotion after bathing Provide extra clothing & blankets for cold intolerance; dress in layers, adjust room temp, and give warm liquids; NO ELECTRIC BLANKETS Promote positive body image return to euthyroid state takes time CNS depressants (barbituates or sedatives) contraindicated b/c risk of respiratory depression If prescribed, dose should be VERY LOW (lower than normal dose) Hypothyroidism lowers metabolism to excrete these med

Osteoporosis Teaching:

Prevent injury - falls that would result in little or no injury in the healthy adult will prob cause fractures in client w/ osteoporosis bed in low position, side rails, night time lighting to toilet facilities avoid using restraints encourage older adults to use assistive devices to maintain independence in ADLs Remove throw rugs, provide adequate lighting clear walkways Avoid inclement weather - Mark threshholds, door ways, and steps Promote balanced nutrition - Postmenopausal women: 1000-1500mg Ca daily - Take calcium and vitamin D supplements with food - Need adequate protein, Mg,vitamin K & other trace minerals for bone formation Relieve acute pain Use heat - a heating pad may offer temporary pain relief; to avoid rebound effect, remove heat every 20-30 minutes NSAIDS can be useful and OTCs - provide continuous administration Orthotic devices are available for immobilization of the spine immediately after a compression fracture Provides support and decreases pain; PT fits devices Teach client how to check for skin breakdown under orthotic device Importance of good posture and body mechanics Log roll when getting out of bed Heat and back rubs for muscle relaxation

The nurse cares for a client in the clinic who is scheduled for a dual x-ray absorptiometry (DXA) scan. The nurse reviews the client's medical record and identifies which risk factor for osteoporosis? The client drinks a shot of whisky daily. The client is of African descent. The client's body mass index is 32. The client's spouse is a smoker.

Smoker

Hyperthyroidism Complications:

Thyroid storm/crisis Airway obstruction Hypocalcemia & tetany Nerve damage

Community education program on reducing the risk of osteoporosis. What information should the nurse include? Avoid sun exposure Take a calcium supplement once a day if at risk Walking is the preferred mode of exercise to maintain strong bones Caffeine intake minimizes risk of developing osteoporosis.

Walking

Cushing's Disease- hypercortisolism Clinical Manifestations

Weakness , fatigue, sleep disturbance Back and joint pain Altered emotional state- irritability, depression Decreased libido Thin, fragile skin Decreased immune function and decreased inflammatory response Bruising and petechiae Hypertension Tachycardia Hyperglycemia Irregular scant menses Dependent edema Fractures- osteoporosis Bone pain & fractures with increased risk of falls Changes in fat distribution- moon face, buffalo hump, truncal obesity Muscle wasting- especially in extremities Impaired glucose tolerance Frequent infections, poor wound healing Hirsutism and Acne Red cheeks Striae - reddish purple lines on the abdomen, upper arms and thighs Clitoral hypertrophy Thinning, bald hair Emotional lability

Addison's Disease Clinical Manifestation:

Weight loss and anorexia Craving for salt- (low sodium levels in blood) N/V, abdominal pain Hyperpigmentation of the skin/mucous membranes Constipation or diarrhea Dizziness with orthostatic hypotension Severe hypotension with acute adrenal insufficiency Dehydration Hypoglycemia & Hyponatremia Hypercalcemia & Hyperkalemia Fatigue

Health Promotion for osteoporosis:

foods rich in vitamin D: most fish, egg yolks, fortified milk, and cereal foods rich in calcium: milk products, green veggies, fortified orange juice & cereals, red and white beans, figs Encourage client to take Ca supplement w/ vitamin D if dietary intake is inadequate or are lactose intolerant. Expose areas of skin to sun 5-30 min twice a week; wear sunscreen Discuss pros and cons of hormone replacement therapy postmenopausally Encourage client to engage in weight bearing exercises (walking, lifting weights) Avoid high impact sports Eat 1000-1500mg Ca

Hyperthyroidism clinical manifestations: T3 and T4 high; TSH low

nervousness, irritability, hyperactivity emotional lability, decreased attention span weakness, easily fatigued exercise intolerance, heat intolerance weight change (usually loss) and increased appetite insomnia and interrupted sleep frequent stools & diarrhea menstrual irregularities (amenorrhea/decreased menstrual flow) Decreased fertility libido initially increased in both men/women, then by a decrease in libido breast enlargement warm, sweaty, flushed skin with velvety-smooth texture tremor, hyperkinesia, hyperreflexia Exophthalmos (grave's disease only) - levels aren't in control vision changes: retracted eyelids, globe lag hair thins Goiter- bruit over thyroid gland elevated systolic BP and widened pulse pressure tachycardia and dysrhythmias

The nurse cares for a client with Addison disease. Which sign or symptom is likely upon assessment? The client reports recent weight gain. The client's blood pressure is hypertensive. The client reports craving salty foods. The client displays behavioral hyperactivity.

salty foods