PrepU Adult 2 Assignment 21
A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience?
A decrease in urine output
Which of the following aspects is an evidence for carpopedal spasm in a client with hypoparathyroidism?
Hand flexing inward
Which nursing diagnosis takes highest priority for a client with hyperthyroidism?
Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Which intervention is the most critical for a client with myxedema coma?
Maintaining a patent airway
For a client with Graves' disease, which nursing intervention promotes comfort?
Maintaining room temperature in the low-normal range
A nurse is caring for a client with Cushing's syndrome. Which would the nurse not include in this client's plan of care?
Provide a high-sodium diet.
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?
Decreased cardiac output
A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:
Calcium gluconate
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?
"I may stop taking this medication when I feel better."
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?
"I will increase my fluid and calcium intake."
A nurse in a postsurgical care unit just received a client who had a hypophysectomy. The nurse is assessing the client for pain. For what behavioral responses should the nurse assess the client when the client is experiencing moderate pain? Select all that apply.
-Facial grimacing -Self-splinting
A patient is diagnosed with overactivity of the adrenal medulla. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla?
450 pg/mL
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?
Acromegaly
Which condition may contribute to hyperparathyroidism?
Chronic renal failure
Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?
Desmopressin (DDAVP)
Which is a clinical manifestation of diabetes insipidus?
Excessive thirst
Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism?
Hypercalcemia
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?
Hypocalcemia
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
Myxedema coma
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
Restricting fluids
A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of:
Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.
Patients with hyperthyroidism are characteristically:
Sensitive to heat
A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?
Serum potassium level of 5.8 mEq/L
A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see?
Serum potassium level of 6.8 mEq/L
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse reaction to the drug?
Tachycardia
The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?
Temperature of 102ºF
A patient taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that he wants to stop taking them because of the increase in acne and moon face. What can the nurse educate the patient regarding these symptoms?
The moon face and acne will resolve when the medication is tapered off.
A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?
Tracheostomy set
When instructing a client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of:
encouraging fluids.
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?
pituitary disorder
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:
profound neuromuscular irritability.
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering:
vasopressin
When caring for a client with diabetes insipidus, the nurse expects to administer:
vasopressin.
A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and:
vitamin D.
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?
Adrenal cortex
The most common cause of hypothyroidism is which of the following?
Autoimmune thyroiditis
A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose?
Goiter
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a client with Cushing's syndrome?
Observe stool color
Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?
Observe stool color.
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome?
Observe the color of stool.
Lydia Kranston, a three-year-old female, is being seen by a physician in the endocrinology group where you practice nursing. She has a significant height deficit and is being seen for diagnostic purposes. What could be the cause of her disorder?
Pituitary disorder
A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
Tetany
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
sodium and potassium abnormalities.
A nurse is providing care to a client hospitalized with adrenal insufficiency. Which nursing interventions would be included in the client's care plan? Select all that apply.
-Encourage client to increase fluid intake. -Instruct the client to ask for assistance getting out of bed.
Anna Brikenwald, a 77-year-old retired chef, is a resident in the long-term care facility where you practice nursing. While she has had a 20-year-history of hypothyroidism, she has progressed into a myxedemic coma and has been admitted to the hospital. What signs and symptoms would have appeared to indicate her worsening condition?
All options are correct
Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy.
Calcium
Barbara Bush, an 83-year-old former First Lady, was diagnosed with Graves' disease. As there is no one cause for the condition which results in Graves' disease, treatment is relegated to the management of symptoms or surgery to correct the condition. Which of the following is not a sign or symptom of Graves' disease?
Constipation
What dietary modifications should be recommended to a client with hyperthyroidism?
Consume a high-protein diet.
A patient has been admitted to an acute medical unit with a diagnosis of diabetes insipidus with a neurogenic etiology. When planning this patient's care, what diagnosis should be the nurse's most likely priority?
Fluid volume deficit related to increased urine output
The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?
Iodine
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?
Myxedema coma
What breakfast items would the nurse recommend when assisting with the breakfast menu for a patient with hyperthyroidism?
Pork sausage and cranberry juice
The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease?
Potassium of 6.0 mEq/L
The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient?
Symptoms of acute coronary syndrome
Dilutional hyponatremia occurs in which disorder?
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?
Weight loss, nervousness, and tachycardia
A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms?
hyperpituitarism
