CM1: Med Surg test THREE - endocrine
which manifestations are exhibited with SIADH? increased BUN and HoTN hyperkalemia and poor skin turgor hyponatremia and decreased UOP polyuria and increased specific gravity
hyponatremia and decreased UOP
a client is admitted with a head injury and has large amounts of clear urine in bag. Which physiological response is possibly causing this? increased glucose deficient renal perfusion inadequate ADH secretion excessive IV fluids
inadequate ADH secretion
Excess thyroid hormones result in a ________________ metabolic rate
increased
which manifestation in a client with SIADH would the nurse expect to find? preservation of salt retention of water decrease of vasopressin presence of pedal edema
retention of water
Hirustism (excessive hair growth) is r/t which endocrine disorder?
Cushings disease
what is the characteristic difference between DM1 and DM2?
DM 1 has a more rapid onset
ketoacidosis is a common complication of which type of diabetes?
DM1
Exophthalmos is a symptom of which disease?
Graves
which cause of tremors, pallor, and diaphoresis would be suspected in a client with DM1? overeating viral infection aerobic exercise missed insulin dose
aerobic exercise
T3 & T4 control the ____________ which can alter the function of almost every body system
basal metabolic rate
while obtaining a client's health history, which factor would the nurse identify as predisposing the client to DM2? having DI eating low-cholesterol foods being 20lbs over weight drinking alcohol daily
being 20lbs over weight
PTH increases bone _________ which stimulates the increase of ___________
breakdown serum calcium
antidiabetic meds can cause ____________
hypoglycemia
which finding would be expected in a client with a history of hypothyroidism? select all a. cold intolerance b. lethargy and fatigue d. 15lb weight gain e. HR 59
cold intolerance lethargy and fatigue 15lb weight gain HR 59
which manifestation would the nurse include when teaching a client about ketoacidosis? select all a. confusion b. hyperactivity c. excessive thirst d. fruity breath e. decreased urine output
confusion excessive thirst fruity breath
which symptom would the nurse monitor for in a client with Addison's disease? pyrexia hypertension hirsutism hypoglycemia
hypoglycemia
which outcome would be expected after a client received treatment for Cushing's disease? increased cortisol levels increased Na+ levels decreased BG levels decreased serum Ca+ levels
decreased BG levels
patients with DM1 are insulin __________
dependent
deficient ADH from the posterior pituitary results in __________
diabetes insipidus
which clinical finding would the nurse expect when assessing a client with hyperthyroidism? select all a. diarrhea b. listlessness c. weight loss d. bradycardia e. decreased appetite
diarrhea cweight loss
a decreased urinary output as a result of SIADH causes what to happen to the electrolytes?
dilution
hyperglycemia acts as an osmotic ___________, resulting in dehydration
diuretic
which skin condition would the nurse expect when preforming a physical assessment on a client with a history of hypothyroidism? dry moist flused smooth
dry
Which symptoms would be observed in a client with hyperglycemia & ketoacidosis? select all a. irritability b. dry skin c. diaphoresis d. increased thirst e. deep, rapid breathing
dry skin increased thirst deep, rapid breathing
What causes Cushing's syndrome?
excess cortisol
which factors can predispose a client with DM1 to a diabetic ketoacidotic coma? select all a. too much insulin b. getting too much exercise c. excessive emotional stress d. running a fever w/ the flu e. eating fewer calories than prescribed
excessive emotional stress & running a fever w/ the flu
which manifestation may indicate that the client with DM1 has insulin-induced hypoglycemia? select all a. excessive hunger b. weakness c. diaphoresis d. excessive thirst e. deep respirations
excessive hunger weakness diaphoresis
when assessing a client with DI which s/s would the nurse anticipate finding? select all a. excessive thirst b. increased BG c. dry mucous membranes d. increased BP e. decreased serum osmolarity f. decreased specific gravity
excessive thirst dry mucous membranes decreased specific gravity
excessive thirst is r/t hyperglycemia bc of ____________
fluid shifts and excessive glucose being excreted in kidneys
s/s of DKA
fruity breath frequent urination n/v belly pain weakness/fatigue
emotional stress stimulates the SNS which releases ___________ which increases ____________
glucocorticoids blood glucose
Cushing's disease affects ___________ and results in reduced glucose uptake by tissues and increased blood ________
glucose metabolism glucose levels
Kussmaul respirations are associated with _________glycemia because the body is trying to get rid of Co2 to compensate for metabolic acidosis
hyper
moist, smooth skin occurs with which type of thyroid issue?
hyperthyroidism
Tetany is a result of ___________
hypocalcemia
which effect does increased PTH have on bones and electrolytes? select all a. increased bone breakdown b. increased serum Ca+ c. increased Na+/phosphorus excretion d. increased absorption of Ca+ and phosphorus e. increased net release of Ca+ and phosphorus
increased bone breakdown increased serum Ca+ increased net release of Ca+ and phosphorus
which would the nurse include in teaching a teen about DM1? insulin therapy prophylactic antibiotics blood glucose monitoring oral hypoglycemic agents adherence to treatment regimen
insulin therapy blood glucose monitoring adherence to treatment regimen
Cushing's disease causes what to happen to your BP?
it goes up r/t fluid & sodium retention
a 15 year old is found to have DI. Which teaching would the nurse include? it doesn't always require insulin it involves early vascular changes it occurs more often in obese teens it has a more rapid onset than DM2
it has a more rapid onset than DM2
which statement is correct regarding calcitonin? it's secreted by follicular cells it's actions are opposite to that of PTH it decreases phosphorus levels by increasing bone reabsorption it works along with thyroid hormone to maintain normal Ca+ levels
it's actions are opposite to that of PTH
Dm1 is often first diagnosed during an episode of acute __________
ketoacidosis
which complication associated with Dm1 should the nurse include in the teaching plan for the parent of a newly diagnosed kid? obesity ketoacidosis resistance to treatment hypersensitivity to other meds
ketoacidosis
a client with DM1 for 25 years states "I have been really bad for the past 15 years. I don't watch my diet and don't control it well". Which common complication might you expect to find? select all a. leg ulcers b. loss of visual acuity c. thick, yellow toe nails d. increased growth of body hair e. decreased sensation in feet
leg ulcers loss of visual acuity thick, yellow toe nails decreased sensation in feet
the focus for patients with DI is _______________-
maintaining fluid and electrolytes
loss of the thyroid gland will upset thyroid hormone balance and may cause _____________
myxedema
do DM1 clients use hypoglycemia agents?
no, bc they are ineffective in stimulating insulin secretion
which responses would the nurse expect a client experiencing hypoglycemia to exhibit? select all a. nausea b. palpitations c. tachycardia d. nervousness e. warm, dry skin f. increased respirations
palpitations tachycardia nervousness
which purpose would KCl add to the IV solution of a client with DKA? treats hyperpnea prevents flaccid paralysis prevents hypokalemia treats cardiac dysrhythmias
prevents hypokalemia
which interventions would the nurse implement in caring for a client with diabetes insipidus after a head injury? select all a. provide adequate fluids b. report an increase in specific gravity c. administer prescribed erythromycin d. assess for & report changes in neuro status e. monitor for constipation, weight loss, hypotension, and tachycardia
provide adequate fluids assess for & report changes in neuro status monitor for constipation, weight loss, hypotension, and tachycardia
when you give insulin for DKA it causes the potassium ions to ________ leading to _________
reenter the cells hypokalemia
which findings would the nurse associated with cushing's disease? select all a. round face b. dependent edema in feet c. increased fatty deposition in extremities d. thin, translucent skin w/ bruising e. increased fatty deposition in neck & back
round face dependent edema in feet thin, translucent skin w/ bruising increased fatty deposition in neck & back
the nurse is providing immediate post-op care to a client with a thyroidectomy. The nurse would monitor them for which manifestation? urinary retention restlessness decreased BP signs of respiratory obstruction
signs of respiratory obstruction
what electrolyte is elevated in hypercortisolism?
sodium
which instruction would be included in the discharge plan for a client status post-total thyroidectomy? take T replacement meds be aware of s/s of dehydration avoid all over the counter meds report signs of hypoglycemia
take T replacement meds
The nurse is educating a newly diagnosed DM2 client on oral diabetic meds. Which should she include? select all a. take a finger prick test before each meal b. you don't need to follow a diet c. s/s of hypoglycemia d. how to administer regular insulin
take a finger prick test before each meal s/s of hypoglycemia
which complication would the nurse be concerned about if there is a removal of the parathyroid glands during a thyroidectomy? tetany myxedema hypovolemic shock adrenocortical stimulation
tetany
what causes DKA?
the body isn't able to produce enough insulin so it breaks down fat instead
Graves disease is characterized by the overproduction of ____________
thyroid hormones
which skin condition would the nurse expect when performing a physical assessment on a client with a new diagnosis of hyperthyroidism? select all a. warm b. moist c. pale d. smooth e. coarse f. dry
warm moist smooth