Disorders of Endocrine Control

The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that additional teaching is needed?

"So I can stop my insulin if I start an exercise program."

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:

06:00 to 08:00 AM

A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

A middle aged obese adult with a sedentary lifestyle

A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the nurse inform him the test should be obtained?

Before 0800

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis?

Beta cell exhaustion due to long-standing insulin resistance

Growth hormone exerts its effects on the body in many ways. Which of these are effects of GH? Select all that apply.

Enhances fatty acid mobilization Increases insulin levels Facilitates the rate of protein synthesis

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?

Random blood glucose 195 mg/dL (10.82 mmol/L)

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply.

Tachycardia Delirium Very high fever

The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

Thin extremities and muscle weakness

A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?

Thyroid storm

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

short acting

A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:

teach the client about the safe and effective use of synthetic thyroid hormones

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

the brain relies on blood glucose as its main energy source

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

the client is achieving normal glycemic control

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?

Maintain healthy blood pressure and blood sugar levels.

A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high). Which response by the client may account for this abnormal lab result?

My meter broke so I have not been checking my blood glucose levels for a while.

the nurse is performing an assessment for a client with Cushing syndrome and observes a "buffalo hump" on the back, a moon face, and a protruding abdomen. What does the nurse understand contributes to the distribution of fat in these areas?

altered fat metabolism

Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?

excess ACTH production by a pituitary tumor

the nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

give the client a concentrated carbohydrate

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

is morbidly obese (defined as greater than 100 pounds over ideal weight).