Endocrine

Which manifestations would the nurse anticipate finding in a patient diagnosed with Cushing's disease?

- acne- moon face- hyperglycemia- elevated cortisol level

A patient taking exogenous glucocorticoids is to be discharged from the hospital. What does the nurse teach the patient and the caregiver?

- adhere to the drug regimen- make a point to receive a flu shot-use proper hygiene and avoid crowds

What lab findings are consistent with a patient diagnosed with hyperaldosteronism?

- arterial ph 7.48- serum sodium 148

What foods should be avoided by a patient diagnosed with pheochromocytoma?

- bacon- cheddar cheese-wine(foods high in tyramine)

What laboratory findings are consistent with a diagnosis of Cushing's disease?

- elevated serum cortisol- increased serum sodium

A patient has been diagnosed with pheochromocytoma. Which factors can trigger a hypertensive crisis?

- increased abdominal pressure- foods high in tyramine- palpation of the abdomen

What nursing interventions are appropriate for a patient diagnosed with adrenal hypofunction?

- monitor BUN levels- monitor hematocrit levels- admin steroid therapy

What medications would the nurse plan to administer to a patient diagnosed with hyperaldosteronism?

- potassium- spironolactone

What teaching should be provided for a patient diagnosed with Addison's disease who is going to be taking a cortisone replacement?

- take it twice a day- monitor weight daily take the medication with food

thyroid storm symptoms (6)

-hyperthermia/fever-tachycardia-heart failure-delirium/confusion-abdominal pain-vomiting, diarrhea

A patient who underwent a thyroid scan tested positive for multiple thyroid nodules. What percentage (%) of radioactive iodine uptake (RAIU) by the thyroid gland does the nurse anticipate?

50%

The nurse is assigned the following four patients. Which patient should the nurse see first?

A patient diagnosed with Addison's disease with a potassium level of 6.0 mEq/L and a sodium level of 127 mEq/L

The nurse is assigned the following four patients. Which patient should the nurse see first?

A patient diagnosed with Cushing's syndrome who just returned from a bilateral adrenalectomy

The nurse is assigned the following four patients. Which patient should the nurse see first?

A patient diagnosed with new-onset type 1 diabetes who now has positive ketones in his urine

A patient is prescribed radioactive iodine (RAI) therapy for hyperthyroidism. What safety precautions should the nurse teach the patient? Select all that apply.

Avoid fruits with a core and meat with bones. Use a separate toilet for at least 2 weeks after RAI therapy. Use a laxative on the second and third day after RAI therapy.

What method must the patient with diabetes use with regard to insulin safety?

Discard any unused insulin after 28 days

The nurse expects what assessment findings in a patient with thyroid cancer? Select all that apply.

Dyspnea-Dysphagia-Hoarseness

A patient who is scheduled for surgery in the morning is placed on NPO status. The patient is scheduled to receive insulin glargine before bed. What action by the nurse should be taken?

Give the insulin

What findings are consistent with a diagnosis of hyperaldosteronism? Select all that apply

Headache Muscle weakness Dehydration

The nurse has just taken a change-of-shift report on a group of patients on the medical-surgical unit. Which patient does the nurse assess first?

Patient taking glyburide who is dizzy and sweaty

What should the nurse be aware of when caring for a patient with acute thyroiditis?

The condition is usually resolved with antibiotic therapy

Which manifestations would the nurse anticipate finding in a patient diagnosed with Cushing's disease? Select all that apply.

acne-moon face-hyperglycemia-elevated cortisol levels

A patient with pheochromocytoma is admitted for surgery. What does the nurse do for the admitting assessment?

avoids palpating the abdomen

What skin change does the nurse expect to find in a patient with hypercortisolism?

reddish-purple striae

myxedema coma causes

stressors (ex: illness, surgery)

A patient suspected of having Cushing's disease is scheduled for dexamethasone suppression testing. What statement by the patient indicates a need for further teaching?

"My blood will be drawn over 3 days."

What are primary causes of adrenal insufficiency? Select all that apply.

Tuberculosis-Hemorrhage- Autoimmune Disease

The nurse is evaluating how well a patient understands the hormonal replacement therapy that has been prescribed for the management of hypothyroidism. Which patient statement indicates a need for further teaching?

"I can stop taking my medications when I feel better

The nurse is teaching a patient who has just been prescribed insulin glargine about administration. What statements by the patient indicate a need for further teaching? Select all that apply.

"I will take this before meals and at bedtime." "If I am hospitalized, I can receive this medication intravenously."

The nurse is precepting a nursing student who is caring for a patient who is on 10 mg prednisone orally for adrenal insufficiency. Which patient instruction provided by the nursing student will be helpful in adjusting the dosage?

"Report if you find any abrupt decrease in your body weight."

A patient with Cushing's disease begins to laugh loudly and inappropriately, causing the family in the room to be uncomfortable. What is the nurse's best response?

"The disease can sometimes affect emotional responses."

A patient has been prescribed radioactive iodine (RAI) therapy for hyperthyroidism. What does the nurse teach the patient about this therapy?

"You will receive RAI in the form of oral131I."

A patient diagnosed with an Addisonian crisis has the following labs: potassium 5.4 mEq/L, sodium 130 mEq/L, calcium 8.0 mg/dL, and blood glucose 70 mg/dL. What medications does the nurse anticipate administering?

-insulin-dextrose-kayexalate

thyroid storm interventions (8)

-maintain patent airway-cardiac monitoring for dysrhythmias-acetaminophen to decrease temperature-cool sponge baths, ice packs, cooling blanket-administer thionamides (propylthiouracil)-administer sodium iodine-administer beta blockers (SNS effects)-supplemental oxygen

myxedema coma interventions

-maintain patent airway-cardiac monitoring-administer thyroid hormones (levothyroxine)-warm blankets (hypothermia)-hydration with 0.9% sodium chloride

What manifestation does the nurse expect to find during the assessment of a patient with pheochromocytoma?

-profuse sweating or diaphoresis-increased abdominal pressure-intermittent episodes of hypertension

myxedema coma symptoms

-respiratory failure-hypotension-hypothermia-bradycardia-dysrhythmias-coma-hypoglycemia-hyponatremia

Which manifestations would the nurse anticipate finding in a patient diagnosed with Addison's disease?

-vitiligo-hyperkalemia-hyperpigmentation

A patient presents to the emergency department with a history of adrenal insufficiency. The following laboratory values are obtained: Na 130 mEq/L, K 5.6 mEq/L, and glucose 72 mg/dL. Which is the first request that the nurse anticipates?

Administer insulin and dextrose in normal saline to shift potassium into cells.

The nurse is caring for a patient who is diagnosed with adrenal insufficiency. The patient has the following lab results: potassium 5.9 mEq/dL, sodium 128 mEq/dL, and calcium 8.0 mg/dL. The patient reports palpitations. What action by the nurse is priority?

Assess the patient's cardiac rhythm

Which nursing action can the home health nurse delegate to a home health aide who is making daily visits to a patient with newly diagnosed type 2 diabetes?

Assist the patient with washing the feet and applying moisturizing lotion

A patient diagnosed with hypothyroidism has been prescribed hormone replacement therapy. What does the nurse teach the patient about this therapy?

Avoid taking over-the-counter (OTC) drugs.

Which should the nurse monitor when caring for the patient receiving fludrocortisone (Florinef)?

Blood Pressure

Which patient does the nurse identify as being at highest risk for acute adrenal insufficiency resulting from corticosteroid use?

Client with shortness of breath and chest tightness, nasal flaring, audible wheezing, and oxygen saturation of 85% for the second time this week

The nurse is caring for a patient with continuous glucose monitoring (CGM) and obtains an elevated reading. Which action would the nurse take first?

Confirm the results with a finger stick test

Which hormones raise blood glucose levels? Select all that apply.

Cortisol-Glucagon-Epinephrine-Growth hormone

A nurse observes a patient who presents with buffalo hump, moon face, and an obese trunk. The skin on the patient's abdomen has reddish striae, and laboratory findings reveal excess levels of cortisol. Which medication does the nurse expect to be prescribed?

Cyproheptadine

A patient has been diagnosed with hyperaldosteronism. What laboratory finding is used to confirm this diagnosis?

Elevated blood pH

A patient admitted with hyperthyroidism is fidgeting with the bedcovers and talking extremely fast. Based on the patient's symptoms, what should the nurse do?

Encourage the patient to rest

A patient is taking fludrocortisone for adrenal hypofunction. The nurse instructs the patient to report which symptom while taking this drug?

Headache

For what adverse effect does the nurse monitor a patient receiving fludrocortisone for Addison's disease?

Hypertension.

While assessing a patient with an endocrine disorder, the nurse hears an audible bruit over the thyroid gland. The presence of a mass or cyst is noted on the patient's ultrasound report. The primary health care provider prescribes radioactive iodine. What condition might the patient be experiencing?

Hyperthyroidism

What post-thyroidectomy complications does the nurse suspect in a patient who complains in a hoarse voice of difficulty breathing and a tingling sensation around the mouth? Select all that apply.

Hypocalcemia Respiratory distress Laryngeal nerve damage

What action should you take for a patient diagnosed with Myxedema Coma (R/T Hypothyroidism)?

IV Infusion of Saline(R?T Iodine deficiency)

A patient diagnosed with glucocorticoid deficiency is prescribed hydrocortisone. What teaching specific to hydrocortisone will the nurse provide?

If you experience rapid weight gain, report this immediately. may be a sign of Cushing syndrome and requires dosage adjustment

What does the nurse expect to find when assessing a patient with hyperthyroidism?

Increased appetite

Which are symptoms of hyperthyroidism? Select all that apply.

Insomnia Palpitations Low-grade fever Restlessness and irritability

A patient has undergone a total thyroidectomy. What postoperative care does the nurse provide?

Inspect the back of the neck and the dressing for blood.

The nurse has determined that a patient diagnosed with Cushing's disease is at risk for injury. What intervention is necessary??

Instruct patient to use an electric razor

A patient has received teaching about the use of basal insulin for glucose stabilization. What selection indicates the teaching has been effective?

Insulin glargine

Which type of thyroid cancer often occurs as part of multiple endocrine neoplasia (MEN) type II?

Medullary carcinoma commonly occurs as part of MEN type II, which is a familial endocrine disorder.

What medication is used for the treatment of Cushing's disease?

Metyrapone

What manifestations should the nurse expect to find in a patient with Cushing's syndrome? Select all that apply.

Moon face-Truncal obesity-Loss of bone density

A patient diagnosed with pheochromocytoma has experienced two intermittent hypertensive attacks. What medication should the nurse assess for as a potential cause of the attack?

Nortriptyline

Which are considered secondary causes of adrenal insufficiency? Select all that apply.

Pituitary tumors Hypophysectomy Abruptly stopping corticosteroids

What is the rationale for administration of ranitidine to a patient who is experiencing acute adrenal insufficiency?

Prevention of gastric ulcers

Which measure helps the patient with type 1 diabetes mellitus (DM) who uses an insulin pump to appropriately manage blood glucose levels?

Reducing the insulin dosage before planned physical exercise

The nurse is teaching a patient about the storage of NPH and regular insulins. Which information does the nurse convey?

Refrigerate insulin vials not in use, or if the ambient temperature exceeds 86° F.

A patient is admitted to the hospital with acute adrenal insufficiency. Which laboratory tests would the nurse expect the health care provider to prescribe? Select all that apply.

Sodium Cortisol Potassium

The nurse is providing discharge instructions to a patient on spironolactone therapy. Which comment by the patient indicates a need for further teaching?

Spironolactone increases potassium levels, so potassium supplements and foods rich in potassium, such as bananas, should be avoided to prevent hyperkalemia. While taking spironolactone, symptoms of hyponatremia such as drowsiness and lethargy must be reported; the patient may need increased dietary sodium.

The nurse is teaching a group of nursing students about the American Diabetes Association (ADA) recommendations for patient care. Which recommendation made by a nursing student indicates understanding?

The LDL cholesterol should be below 100 mg/dL for patients without signs of CVD

A patient's preliminary thyroid function test reveals a decrease in serum triiodothyronine (T 3) and tetraiodothyronine (T 4) hormone levels, which might indicate hypothyroidism. What other parameter should be assessed to determine the origin of hypothyroidism as primary or secondary?

Thyroid-stimulating hormone (TSH) stimulation test

What should be suspected in a 60-year-old female patient diagnosed with a goiter who does not display signs of exophthalmos and pretibial myxedema?

Toxic multinodular goiter

A patient has been prescribed divided doses of prednisone. How should the patient take this drug?

Two-thirds in the morning and one-third in the late afternoon

A patient with hypercortisolism is at risk for bone fractures. What does the nurse instruct the unlicensed assistive personnel (UAP) to do when caring for this patient?

Use a gait belt to assist the patient when walking

A patient with type 1 diabetes has had multiple episodes of hypoglycemia. What teaching by the nurse may be indicated?

Use the fingertip only for blood glucose checks

The nurse is teaching a patient with diabetes mellitus how to inject a mixture of NPH and regular insulins. In which order does the nurse instruct the patient to prepare and administer the insulin?

Wash the hands Swab the rubber stoppers of the vials with alcohol Wipe the skin with alcohol Draw up regular insulin. Draw up NPH insulin. Inject the insulin at a 90-degree angle.

A patient recently admitted with new-onset type 2 diabetes will be discharged with a self-monitoring blood glucose machine. When is the best time for the nurse to explain to the patient the proper use of the machine?

While performing the test in the hospita

What lab findings are consistent with a patient diagnosed with hyperaldosteronism?

arterial ph 7.48- serum sodium 148

myxedema coma

hypothyroidism - life-threatening condition that occurs when hypothyroidism is untreated or when a stressor affects a pt with hypothyroidism

A patient with a diagnosis of Cushing's disease has been hospitalized. What care is priority for this patient?

treating fluid overload

What is a common side effect of spironolactone therapy for hyperaldosteronism?

urticaria or hives as a side effect.