Endocrine disorders 2.23

A client with Addison's disease will most likely exhibit which symptom? A. Hypertension B. Bronze pigmentation C. Hirsutism D. Purple striae

Answer B is correct. Answer B is correct because a bronze pigmentation is a sign of Addison's disease. Answers A, C, and D are symptoms of Cushing's syndrome, making them incorrect.

Would you expect hair loss in addisons or cushings? 1. Addisons 2. Cushings

1. Addisons (Cushings you actually have increased hair growth)

What are some nursing diagnosis could you use for a patient who has diabetes inspidus? 1. Cold intolerance 2. Fluid overload 3. Dehydration 4. Dysphagia 5. Hypotension 6. Polydipsia

3- Dehydration 5- Hypotension 6- Polydispsia (causes polyuria-extremely dilute urine)

3. A nurse is preparing to perform an assessment on a client being admitted to the hospital with a diagnosis of Cushing's syndrome. When performing the assessment, the nurse checks for which significant manifestation of the disorder? a) fluid retention b) stretch marks c) goiter d) melanosis

3) A - Excessive secretion of adrenocortical hormones results in water and sodium reabsorption, causing fluid retention. Stretch marks (striae) are a common feature and can result in a disturbed body image, but are not significant and do not represent a life-threatening situation. Goiter is not a manifestation of Cushing's syndrome. Melanosis is a common manifestation associated with Addison's disease.

Your patient is feeling dizzy, they're nauseous as well as vomitting and experiencing joint pain. What disease might this be? 1. Grave 2. Cushings 3. Addisons 4. SIADH

3. Addisons

The nurse was questioning the admission orders by the doctor for a patient who has SIADH. Which order might she be questioning? 1. Lab results for sodium, urine sodium, urine specific gravity, serum osmolality 2. Nutrition expert to help with anorexia 3. Fluid bolus to help with dehydration 4. Demeclocycline to help treat infections

3. Fluid bolus to help with dehydration Because the pt is already retaining a lot of water

What might the nurse expect when taking the vitals of a pt with addisons? 1. Increased BP 2. Decreased HR 3. Increased temp 4. Decreased resp rate

3Increased temp, s/sx of addisons include fevers

A client with Cushing's syndrome should be instructed to: A. Avoid alcoholic beverages B. Limit the sodium in her diet C. Increase servings of dark green vegetables D. Limit the amount of protein in her diet

Answer B is correct. A client with Cushing's syndrome has adrenocortical hypersecretion, so she retains sodium and water. The client may drink alcohol in moderation, so answer A is incorrect, and there is no need to eat more green vegetables or limit protein, so answers C and D are incorrect.

Select all that apply: Which of the following are signs and symptoms of Grave's Disease: A. Heat Intolerance B. Weight gain C. Bradycardia D. Goiter E. Pretibial Myxedema F. Cold intolerance G. Ophthalmopathy changes H. Fast Heart Rate

A, D, E, G, H

Which of the following symptoms is not typical of Cushing's syndrome? Answers: A. Osteoporosis B. Weight loss C. Diabetes D. Mood instability

B Cushing's syndrome tends to produce rapid weight gain, not weight loss.

A nurse is caring for a client with Cushing's syndrome who demonstrates withdrawn behavior. The nurse recognizes that this client's behavior is likely related to which nursing diagnosis? a) deficient diversional activity b) powerlessness c) hopelessness d) disturbed body image

D - Physical changes in the client's appearance can occur with Cushing's syndrome. Such changes include hirsutism, moon face, buffalo hump, acne, and striae. These changes cause a body image disturbance. Options A, B, and C are not commonly associated with Cushing's syndrome.

Which of the following statements are CORRECT about Grave's Disease? 1. Grave's Disease is caused by independently functioning nodular goiters producing excessive amounts of T3 and T4. 2. Grave's Disease is a complication of untreated hypothyroidism. 3. autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body). 4. Grave's Disease patients do not present with protruding eyes or a goiter, as in Toxic Nodular Goiter (TNG)

3. autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body).

Your patient has been asking for a lot of french fries, instant noodles, pretzels, potato chips etc, what endocrine disease might this be related to? 1. Graves 2. Addisons 3. SIADH 4. Diabetes Insipidus

Addisons disease- craving for salty foods

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? a. Fluid intake is less than 2,500 ml/day. b. Urine output measures more than 200 ml/hour. c. Blood pressure is 90/50 mm Hg. d. The heart rate is 126 beats/minute

a. Fluid intake is less than 2,500 ml/day Diabetes insipidus is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Treatment with the appropriate drug should decrease both oral fluid intake and urine output. A urine output of 200 ml/hour indicates continuing polyuria. A blood pressure of 90/50 mm Hg and a heart rate of 126 beats/minute indicate compensation for the continued fluid deficit, suggesting that treatment hasn't been effective

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in: a. Serum glucose level. b. Hair loss. c. Bone mineralization. d. Menstrual flow.

a. Serum glucose level. Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment, bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it.

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? a. Tetanic contractions b. Neck vein distention c. Weight loss d. Polyuria

b. Neck vein distention SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. This syndrome isn't associated with tetanic contractions. It may cause weight gain and fluid retention (secondary to oliguria).

A patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluates that treatment has been effective when the patient experiences a. increased urine output, decreased serum sodium, and increased urine specific gravity b. increased urine output, increased serum sodium, and decreased urine specific gravity c. decreased urine output, increased serum sodium, and decreased urine specific gravity d. decreased urine output, decreased serum sodium, and increased urine specific gravity

b. increased urine output, increased serum sodium, and decreased urine specific gravity (rationale- the patient with SIADH has water retention with hyponatremia, decreased urine output and concentrated urine with high specific gravity. improvement in the patient's condition reflected by increased urine output, normalization of serum sodium, and more water in the urine, decreasing the specific gravity.)

What is the difference between cushing syndrome and cushings disease 1. Syndrome- disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol, Disease- pituitary tumor 2. Syndrome pituitary tumor, Disease- disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol,

Syndrome- disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol, Disease- pituitary tumor

What main nursing goal do you want for your patient who has diabetes insipidus? 1. Weight gain 2. Fluid and electrolyte balance 3. Decrease N/V 4. Decrease hypotension

2. Fluid and electrolyte balance

Your patient has syndrome of inappropriate antidiuretic hormone secretion where excess ADH is released but not because your body needs it, this can result in water intoxication and hyponatremia which orders would you question the doctor about? 1. Fluid restriction: limit to 1000 ml per day 2. Suck on hard candies, ice chips, sugarless gum to help decrease thirst 3. Low sodium/ Low potassium diet 4. Take Demeclocycline on empty stomach

3. Low sodium/low potassium diet You actually want a high sodium high potassium diet. You are on fluid restrictions!!!!!! You should take demeclocycline on an empty stomach

A patient comes in complaining of heart palpitations, always feeling tired, feels so warm, experiencing weight loss and diarrhea. What might you suspect when you look at her eyes and they are either afraid or enlarged? 1. Myocardial infarction 2. Flu 3. Graves exacerbation 4. Addisons exacerbation

3. This patient is having an exacerbation of graves disease. If a female most likely experiencing menstrual irregularities

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.

c. Deposits of adipose tissue in the trunk and dorsocervical area Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.