Diabetic Emergencies
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
10 to 15 g of a simple carbohydrate
What pharmacologic therapy does the nurse anticipate administering when the patient is experiencing thyroid storm? (Select all that apply.)
Acetaminophen Iodine Propylthiouracil
Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome?
Administer 2 to 3 L of IV fluid rapidly.
A nurse is caring for an older adult client who has type 2 diabetes mellitus. She suspects that the patient is exhibiting symptoms of diabetic ketoacidosis (DKA) instead of hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Which of the following are indicators of a diagnosis of DKA? Select all that apply.
Blood glucose level of 280 mg/dL Arterial pH of 7 Plasma bicarbonate level of 13 mEq/L
A client is brought to the emergency department by the paramedics. The client is a type 2 diabetic and is experiencing hyperglycemic hyperosmolar syndrome (HHS). The nurse should identify what components of HHS? Select all that apply.
Glycosuria Dehydration Hypernatremia Hyperglycemia
Thyroid storm is a severe form of hyperthyroidism that can be fatal if not treated. Medical management includes pharmacotherapy. Which of the following drugs have proved helpful? Select all that apply.
Hydrocortisone Acetaminophen Methimazole Iodine
A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which statement indicates that the client understands his condition and how to control it?
I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual.
Exercise lowers blood glucose levels. Which of the following are the physiologic reasons that explain this statement. Select all that apply.
Increases lean muscle mass Increases resting metabolic rate as muscle size increases Decreases total cholesterol Increases glucose uptake by body muscles
A nurse prepares teaching for a client with newly-diagnosed diabetes. Which statements about the role of insulin will the nurse include in the teaching? Select all that apply.
Insulin permits entry of glucose into the cells of the body. Insulin promotes synthesis of proteins in various body tissues. Insulin promotes the storage of fat in adipose tissue.
A hospitalized, insulin-dependent patient with diabetes has been experiencing morning hyperglycemia. The patient will be awakened once or twice during the night to test blood glucose levels. The health care provider suspects that the cause is related to the Somogyi effect. Which of the following indicators support this diagnosis? Select all that apply.
Normal bedtime blood glucose Increase in blood glucose from 3:00 AM until breakfast Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM
The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know can be used intravenously? Select all that apply.
Rapid-acting Short-acting
Which laboratory test results should a nurse expect to find in a client diagnosed with Hashimoto's thyroiditis?
T4, 2 µg/dl; T3, 35 ng/dl; TSH 45 mIU/ml
A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do?
Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.
A client with diabetes calls the clinic reporting a "flu bug." What should the nurse tell the client to do? Select all that apply.
Try to eat small amounts of carbs, if possible." Take your usual dose of insulin."
A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?
an irregular apical pulse
During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently?
assess vital signs
A group of students is reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla?
epinephrine
Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease?
have regular follow up care
A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion?
hydrocortisone
During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:
phosphorous