Endocrine

What is the normal range of urine specific gravity?

1.005 to 1.030

Hyperthyroidism diagnostics:

A thyroid scan and a thyroid-stimulating hormone test are used to diagnose hyperthyroidism

A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take? (A) Administer IV hydrocortisone sodium. (B) Give oral spironolactone. (C) Infuse 1 unit of platelets. (D) Restrict daily fluid intake.

Administer IV hydrocortisone sodium [Hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency] (Administering a potassium-sparing diuretic, such as spironolactone, will further increase the client's potassium level, worsening the hyperkalemia) (infusing platelets is not appropriate for a client who has acute adrenal insufficiency) (Acute adrenal insufficiency causes hypovolemia, which is an indication for rapid fluid replacement)

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following adverse effects should the nurse include? (Select all that apply.) [ ]Osteoporosis [ ] Moon-shaped face [ ] Increased risk of infection [ ] Hearing loss [ ] Weight loss

[ ] Osteoporosis [ ] Moon-shaped face [ ] Increased risk of infection (Long-term corticosteroid therapy can cause cataracts and glaucoma, but it does not cause hearing loss) (Long-term corticosteroid therapy is more likely to cause weight gain due to fluid and sodium retention)

What are signs of hypoglycemia?

cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion

How often should a type 1 DM patient check their blood sugar?

every 4 hours

Hyperthyroidism symptoms

heat intolerance, weight loss, diaphoresis, anxiety, irritability, hyperactive reflexes, palpitations, EXOPTHALMOS (lid lag when gaze moves from downward to upward), Increased libido, increase bowel movements

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include? (A) "Drink at least 3 liters of fluid per day." (B) "Weigh yourself weekly while wearing similar clothing at the same time of day." (C) "Notify the provider of a weight loss of 1 pound or more per week." (D) "Report nocturia because it requires a dosage adjustment."

"Report nocturia because it requires a dosage adjustment." [The client should take the initial dose of desmopressin in the evening. The provider will increase the dosage until the client no longer has nocturia] (A weight gain or loss of 0.45 kg (1 lb) per week is not enough to suggest overhydration or dehydration) (The client should weigh himself daily to detect dehydration in its early stage) (The client should drink an amount of fluid equal to his urine output each day)

A nurse is teaching a client who is scheduled for a vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching? (A) "Start fasting at midnight prior to the day of the test." (B)"Begin the 24-hour urine collection with the first morning urination." (C) "Take low-dose aspirin for pain during the testing period." (D) "Restrict coffee intake 2 to 3 days prior to the test."

"Restrict coffee intake 2 to 3 days prior to the test." [The client should avoid coffee and tea, even if they are decaffeinated, bananas, chocolate, and vanilla for 2 to 3 days prior to the test] (The client does not have to fast prior to the test, but there are foods the client should avoid, such as bananas and citrus fruits) (The client should discard the first morning urine, and then collect all urine after that for 24 hr) (The client should avoid aspirin because it can affect test results)

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? (A) "Take this medication on an empty stomach." (B) (C) (D)

"Take this medication on an empty stomach." [To promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after] (Aluminum-containing antacids and calcium supplements can reduce the effectiveness of thyroid replacement therapy) (This medication can increase blood glucose levels in clients who have diabetes mellitus. However, it does not cause orthostatic hypotension) (Since there are no fluid restrictions with this medication therapy, the client should drink 2 to 3 L of fluid daily)

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following client statements indicates an understanding of the teaching? (A) "I need to fast after midnight the night before the test." (B) "This test's result is a good indicator of my average blood glucose levels." (C) "A level of 8 to 10 percent suggests adequate blood glucose control." (D) "I will use my hemoglobin A1c level to adjust my daily insulin doses."

"This test's result is a good indicator of my average blood glucose levels." [HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs] (The client does not need to fast before blood sampling for HbA1c. What the client eats the day before has no effect on the results of this test.) (The expected reference range for HbA1c is 4-6% for adults. A result greater than 6.5% can indicate diabetes) (The client should use capillary blood glucose levels to adjust daily insulin doses with the provider's approval)

Diabetes insipidus diagnostic tests:

(1) A 24-hr measurement of I&O (2) urine specific gravity (3) urine osmolarity

What exceeding level of blood glucose should the patient call the provider and when should the client check their urine for ketones?

(1) Call HCP if blood glucose levels exceed 25 mg/dL (2) Check for ketones when blood glucose levels exceed 240 mg/dL

What are clinical manifestations of hypocalcemia and what is the therapeutic Range based by ATI NCLEX?

(1) Clinical manifestations - Strong, bounding pulse - Increase GI motility - paresthesia (starts in hands & feet) - Hyperactive deep-tendon reflexes (2) Lab Value: 9.0-10.5 mg/dL

Thyroid storm

(1) increased temp - >38.5 Celsius (101.3 F) (2) pulse: >130 bpm (3) HTN: - systolic HTN (4) Mental Status - Confusion - Restlessness - Sleepiness

Pheochromocytoma diagnostics:

A 24-hr urine collection can detect catecholamines and other substances that can indicate pheochromocytoma

A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)? (A) Decreased urine output (B)Weight gain of 0.45 kg (1 lb) in 24 hr (C) Rapid, shallow respirations (D) Blood glucose levels above 300 mg/dL

Blood glucose levels above 300 mg/dL [Blood glucose levels above 300 mg/dL are an expected finding of DKA. Levels above 600 mg/dL are an expected finding in a client who is in a hyperglycemic-hyperosmolar state] (Deep, labored breathing, known as Kussmaul respirations, is an expected of DKA)

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? (A) Moon-shaped face (B)Weight gain (C) Calcium 12.8 mg/dL (D) Sodium 150 mEq/L

Calcium 12.8 mg/dL [A client who has adrenal insufficiency will have a calcium level above the expected reference range of 9.0 to 10.5 mg/dL] (A client who has adrenal insufficiency will have a sodium level below the expected reference range of 136 to 145 mEq/L) (A rounded face, or a moon-shaped face, is a finding of Cushing's disease) (Weight loss is a finding of adrenal insufficiency)

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? (A) Inject the insulins intramuscularly. (B) Shake the insulins vigorously prior to administration. (C) Draw up the insulins into separate syringes. (D) Expect the insulins to appear cloudy.

Draw up the insulins into separate syringes. [glargine is not compatible with other insulins] (The nurse should instruct the client to expect both insulins to appear clear and to discard any that appear cloudy)

A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take? (A) Elevate the head of the client's bed. (B) Palpate the client's abdomen. (C) Monitor the client for hypotension. (D) Check the client's urine specific gravity.

Elevate the head of the client's bed. [The nurse should elevate the head of the client's bed to reduce blood pressure and abdominal pressure] (The nurse should not palpate the abdomen of a client who has a pheochromocytoma, because this can cause release of catecholamines and increase blood pressure) (The nurse should monitor a client who has a pheochromocytoma for hypertension) (The nurse should monitor the urine specific gravity of a client who has diabetes insipidus)

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy? (A) Fasting Blood Glucose 96 mg/dL (B) Postprandial blood glucose 195 mg/dL (C) Random blood glucose level of 210 mg/dL (D) Preprandial blood glucose 60 mg/dL

Fasting blood glucose 96 mg/dL [range of 70 to 110 mg/dL] (A postprandial blood glucose level of 195 mg/dL is above the expected reference range of less than 180 mg/dL) (A random blood glucose level of 210 mg/dL is above the expected reference range of less than 200 mg/dL) (A Preprandial blood glucose level of 60 mg/dL is below the expected reference range 70 to 130 mg/dL)

A nurse is reviewing the laboratory results of a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings? (A) Lymphocyte count (B) Potassium (C) Calcium (D) Glucose

Glucose [Blood glucose is elevated in a client who has Cushing's disease] (other lab values are low with clients who have Cushing's disease)

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? (A) Decreased blood pressure (B) Weight loss (C) Hirsutism (D) Increased skin thickness

Hirsutism [Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production] (Thinning of the skin is an expected finding of Cushing's disease)

A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective? (A) Increased ability to sweat (B) Increased bowel movements (C) Increased body weight (D) Increased libido

Increased body weight [Propylthiouracil suppresses the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high] (Propylthiouracil is an antithyroid agent that is expected to decrease diaphoresis) (Increased bowel movements is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease bowel movements) (Increased libido is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease libido)

A nurse is monitoring a client who is 24 hr postoperative after a total thyroidectomy. Which of the following findings should the nurse report to the provider? (A) Laryngeal stridor (B)Productive cough (C) Pain with hyperextension of the neck (D) Hoarse, weak voice

Laryngeal stridor [Laryngeal stridor is a harsh, high-pitched sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway] (Other choices are expected findings)

A nurse is caring for a client who has type 2 diabetes mellitus and is experiencing a hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? (A) Serum pH 7.32 (B) Blood glucose 250 mg/dL (C) Blood glucose 425 mg/dL (D) Serum pH 7.45

Serum pH 7.45 [A client who is experiencing HHS produces enough insulin to prevent ketosis but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range. Glucose levels will be above 600 mg/dL] (This laboratory value indicates the client has diabetic ketoacidosis. Clients who are experiencing HHS will have a pH greater than 7.40) (This laboratory value indicates the client has hyperglycemia. Clients who are experiencing HHS will have a blood glucose level greater than 600 mg/dL) (This laboratory value indicates the client has hyperglycemia. Clients who are experiencing HHS will have a blood glucose level greater than 600 mg/dL)

Addison's disease diagnostics:

The nurse should instruct the client that the ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? (A) Cold intolerance (B)Lethargy (C) Tremors (D) Sunken eyes

Tremors [Findings of hyperthyroidism include tremors, diaphoresis, and insomnia] (A client who has hyperthyroidism can experience heat intolerance) (A client who has hyperthyroidism can be restless and irritable) (A client who has hyperthyroidism can have exophthalmos, which causes a wide-eyed or startled appearance)