Week 6 NR283 Patho

Which statement suggests the possibility of hypothyroidism?​

"I am always tired, even with 10 or 12 hours of sleep."​

A client with hypothyroidism as a result of Hashimoto's thyroiditis asks the nurse how long they will have to take thyroid medication. Which is the best response by the nurse?​

"You'll need thyroid replacement therapy for life because the gland function will not return."​

Review the symptoms below and match them to the condition of excessive or missing hormones.

(TOP LEFT) 1. Addisons (TOP RIGHT) 2. Hypothyroidism (BOTTOM LEFT) 3. Hyperthyroidism (BOTTOM RIGHT) 4. Cushing's syndrome

Question 2 / 4 Risk Factors: What Could It Mean?​ Click to download the document, "Prediabetes Risk Test" (American Diabetes Association & CDC, n.d.). Use Rita's information to complete the test and then use the test results to answer the question.​​ With a total score of ______, Rita ______ at high risk for _____ diabetes.​

6 Is Type 2

Which factors put an individual with type 2 diabetes at high risk for hyperosmolar hyperglycemic syndrome (HHS)? Select all that apply.​

77 years old​ Has influenza Recent myocardial infarction​

For how long should a person avoid all caloric intake prior to a fasting blood glucose test?

8 hrs

In hormone regulation, which statement best describes the negative feedback loop?​

A reaction that causes a decrease in function to help maintain homeostasis

President John F. Kennedy took steroids for a cortisol and aldosterone deficiency. Which condition is caused by such a deficiency?​

Addisons disease

Which aspect of care is often challenging for an adolescent living with diabetes type 1?​

Adhering to a healthy diet

When hormonal alterations are prolonged, what are possible results? Select all that apply.​​

All are correct

Which statement describes a secondary endocrine disorder?​

An endocrine gland does not secrete enough hormones to stimulate another endocrine gland to secrete a different hormone.​

Which finding is the most common cause of hypothyroidism?​

Autoimmune thyroiditis

In what way does insulin facilitate glucose entry into the cell?​

Binds to cell membrane receptors

Rita (pronouns she/her), a 58-year-old female, is concerned about the risks of becoming a diabetic. She is 5'9" tall and weighs 204 pounds, walks 5 miles 6 days per week, takes medicine for high blood pressure, has never been pregnant, takes vitamin D supplements prescribed by her healthcare provider, and both of her parents had a history of diabetes mellitus. ​ Question 1 / 4 Risk Factors: What Matters Most? ​ Which findings increase Rita's risk of diabetes? Select all that apply.​

Body mass index of overweight​ Takes medication for high blood pressure​ Both parents had diabetes mellitus​ Vitamin D deficiency

Which situation or condition is likely to result in an increased production of thyroid hormones?​

Cold environmental exposure

Question 4 / 4 Risk Factors: How Can This Be Prevented?​ What steps can Rita take to decrease the risk of diabetes? Select all that apply.​

Continue walking for exercise Eat a well-balanced diet​

Which conditions are macrovascular complications of diabetes mellitus? Select all that apply.​

Coronary artery disease Peripheral vascular disease​

Which condition is associated with over secretion of adrenocorticotropic hormone (ACTH)?​

Cushing's syndrome

Thyroid hormone deficit causes vitamin _____________,, which alters the function of ______ major organs in the body.​

Decrease metabolism all

If a client has a low dietary intake of iodine (iodide), which hormone would be most profoundly affected and how would it be affected?​

Deficiency of thyroid hormones

A person with a hemoglobin A1C of 7% and a fasting blood glucose level of 213 mg/dL is most likely experiencing which condition?

Diabetes

Which clinical manifestation distinguishes hypoglycemia from diabetic ketoacidosis (DKA)?

Diaphoresis

Question 4 / 4 How Can This Be Prevented? How could this individual avoid hypoglycemia in the future? Select all that apply.​

Eating complex carbohydrates​ Making healthy food choices​

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency room (ER). Which findings confirm this diagnosis?​ Select all that apply.

Elevated blood glucose level Increased respiration Decreased serum pH

Which hormones alter glucose regulation? Select all that apply.​

Epinephrine Insulin Glucagon Cortisol

Which signs or symptoms are common and may be seen after someone experiences a traumatic brain injury? Select all that apply.​

Excessive urination​ Intense thirst​ Dilute urine​

Which behaviors will help maintain a healthy blood glucose level? Select all that apply.​

Exercise Regular exams Medications

Question 3 / 4 Risk Factors: What Is Happening?​ Which laboratory test would be used to determine if Rita does have diabetes mellitus?​

Fasting blood glucose test

For which tests that determine blood sugar levels should a person have no caloric intake for at least eight hours? Select all that apply.​

Fasting blood glucose​ Glucose tolerance test​

Select the items that may impact someone's insulin requirements. Select all that apply.

Food Illness Exercise

Which substance is the primary source of energy within the cells?​

Glucose

A client is in the clinic to have a laboratory test to evaluate long-term glycemic control. Which test should be ordered?​

Glycosylated hemoglobin​

A neighbor shares that their 12-year-old child has not been doing well in school because of blurred vision and being tired all the time. The parent is concerned because the child is frequently hungry but losing weight despite "eating all the time" and, starting about three months ago, has been very thirsty and urinating frequently. The parent's partner thinks they should not be concerned, saying the child's sports activities are causing these changes. Three weeks later, the neighbor shares that the child has been diagnosed with diabetes mellitus. What information supports the diagnosis of type 1 diabetes? Select all that apply.​

Hemoglobin A1C 7.6% Older sister and cousin have type 1 diabetes Very dry skin

Which information best indicates that an individual living with type 2 diabetes has not achieved good glucose control of their diabetes mellitus over time?​

Hemoglobin A1C 9%

A middle-aged adult with type 2 diabetes should have which routine testing to monitor the effectiveness of treatment? ​

Hemoglobin A1C annually for all clients over age 50​

An older adult living with type 2 diabetes mellitus has pneumonia. For which complication is this person at highest risk?​

Hyperosmolar hyperglycemia syndrome (HHS)​

Question 2 / 3 Prioritizing Hypotheses ​ The client is at risk of developing _________ as evidenced by the _________

Hyperthyroidism Physical assessment

An older adult experiencing tachycardia, cold and clammy skin, tremors, dizziness, and slurred speech is most likely having which alteration in glucose regulation?​

Hypoglycemia

Question 3 / 4 What Is Happening? Based on the information provided, which alteration in glucose regulation is occurring?​

Hypoglycemia

Which signs or symptoms indicate excessive antidiuretic hormone levels? Select all that apply.​

Hyponatremia​ Concentrated urine

Which part of the body is the main control center for hormonal regulation?​

Hypothalamus

What are the risk factors for type 2 diabetes?​ Select that all apply.

Inactivity Diet high in simple carbohydrates Metabolic syndrome​ Insulin resistance

A person at risk for type 2 diabetes who wants to avoid the disease should follow which dietary practices? Select all that apply.​

Increase daily fiber intake. Eat fish at least two times per week.

Which statement about medications used to treat type 2 diabetes is correct?​

Many medications increase the effect of insulin on the cells.

Hormone levels are primarily controlled through _______ feedback loops, in which _________ of a hormone inhibit its further release. ​

Negative Rising

Which is the most common cause of a pituitary disorder?​

Non-cancerous tumor​

Doug (preferred pronouns: he, him), a 27-year-old male, was in a motorcycle accident. He was not wearing a helmet and sustained a traumatic brain injury. You are the case manager seeing him just after the accident. He appears confused and nauseated. He is bothered by dizziness. He has been urinating frequently. You note that his urine is clear. Laboratory tests show: the potassium level is normal, the sodium level is high, and the glucose level is low. Question 1 / 3 What Is Happening?​ Which are increased risk factors for a pituitary disorder?​ Select that all apply.

Not wearing helmet Traumatic brain injury

During labor, ___________ released from the posterior pituitary gland is an example of a _________ loop.​

Oxytocin Positive

An individual is 38-weeks pregnant. They are having contractions 7-8 minutes apart. Their healthcare provider ordered lab tests revealing that their blood sugar was high and androgen levels were high. ​ What Could It Mean? Which hormonal alteration is likely occurring with excess androgens?

PCOS

Which external factors can affect hormone secretion in all systems? Select all that apply.

Pollution Sunlight Chemicals Stress

An individual is 38-weeks pregnant. They are having contractions 7-8 minutes apart. Their healthcare provider ordered lab tests revealing that their blood sugar was high and androgen levels were high. ​ What Does It Mean? Which type of mechanism is occurring during the contraction and laboring process?​

Positive feedback loop

What type of regulation causes insulin to be released after eating a high carbohydrate meal?

Positive feedback loop

Which factor places a person at risk of developing diabetes mellitus type 1?

Presence of autoantibodies

What is a risk factor for type 1 diabetes?

Recent infection

Where is the pituitary gland located?​

Sella turcica of the brain​

Question 3 / 3 Generating Solutions​ Which diagnostic tests can the nurse anticipate the healthcare provider ordering for this client? Select all that apply.​

T3 TSH T4

Which statement best describes insulin resistance?​

There is insulin in the blood, but insulin receptors do not respond to it.​

Which hormone deficiency is the highest priority?​

Thyroid - stimulating hormone

An individual has a history of unplanned weight loss despite increased appetite, fatigue, and heart palpitations. The individual observes a palpable mass on the anterior portion of the neck, next to the trachea.​ Which diagnostic test do you anticipate the healthcare provider ordering for this individual? ​

Thyroid function test

An older adult who is 5'4'' tall and weighs 248.6 pounds has a wound on the left lower leg that has not healed in two weeks. Regarding the type of diabetes mellitus, this person is most likely to have ___________

Type 2 diabetes

Which hormonal alterations can be considered age related? Select all that apply.​​

Type 2 diabetes Menopause

Two coworkers are leaving work after a very busy day during which neither was able to eat anything. As they wait for a bus, they talk about their weekend plans. One adult coworker suddenly becomes pale, diaphoretic, tired, and confused. The two have worked together for three years and this has not happened before.​ Question 1 / 4 What Matters Most? What information indicates the coworker is experiencing an alteration in glucose regulation? Select all that apply.​

Weak or tired Diaphoretic Pale

Question 3 / 3 How Can This Be Prevented?​ Which strategy could prevent Doug's pituitary disorder?​

Wearing a helmet