Endocrine Questions Acute and Chronic

599. A client has been diagnosed with hyperthyroidism. Which signs and symptoms may indicate thyroid storm, a complication of this disorder? Select all that apply.

.Fever 2.Nausea 3.Lethargy 4.Tremors 5.Confusion 6.Bradycardia 1, 2, 4, 5

pt has low T3 level. If the tsh level is elevated what does this mean..

Cause is most likely primary hypothyroidism

TSH stim/inhibited by

Dec t3 inc t3

in a pt w inc serum cortisol, what else might you see

Hypokalemia cortisol is glucocorticoid but can have mineral fx - so excrete K and absorb Na

The patient with systemic lupus erythematosus had been diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse expect to include in this patient's plan of care (select all that apply)?

Keep the head of the bed at 10 degrees or less elevation. Correct limit fluids to 1000 ml per day

The surgeon was unable to spare a patient's parathyroid gland during a thyroidectomy. Which assessments should the nurse prioritize when providing postoperative care for this patient?

Monitoring the patient's serum calcium levels and assessing for signs of hypocalcemia Correct

What is a nursing priority in the care of a patient with a diagnosis of hypothyroidism?

Patient teaching related to levothyroxine (Synthroid) Correct

if papate thyroid what can happen..

Release of more thyroid hormone into circulation which may lead to thyroid storm

The nurse is providing discharge instructions to a patient with diabetes insipidus. Which instructions regarding desmopressin acetate (DDAVP) would be most appropriate?

The patient should alternate nostrils during administration to prevent nasal irritation. Correct

Inc ANP inhibits the secretion of..

aldosterone

The nurse should monitor for increases in which laboratory value for the patient as a result of being treated with dexamethasone (Decadron)?

blood glucose

Aldosterone stim/inhibited by

dec BP inc BP

PTH stim/inhibited by

dec calcium inc calcium

Female admitted with cushing syndrome with elevated serum and urine cortisol. Assessment findings?

elevated BP and blood glucose

Endocrine issues commonly attributed to aging in elderly..

fatigue and mental impairment

Assessment findings related to abnormal thyorid fx

heat intolerance in hyperfunction exophthalamos with inc secretion hyperpigmentation with hypofunction

Labs for Addison's crisis

hyperkalemia hyponatremia hypochloremia anemia Inc BUN hypoglycemia low urine cortisol

Calcitonin stim/inhibited by

inc calcium dec calcium

The patient is brought to the ED following a car accident and is wearing medical identification that says she has Addison's disease. What should the nurse expect to be included in the collaborative care of this patient?

inc glucocorticoid replacement

ADH stim/inhibited by

inc plasma osmolality dec plasma osmolality

ACTH stim/inhibited by

inc stress inc serum cortisol

The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for what manifestation?

lethargy and weakness

A patient has been taking oral prednisone for the past several weeks after having a severe reaction to poison ivy. The nurse has explained the procedure for gradual reduction rather than sudden cessation of the drug. What is the rationale for this approach to drug administration?

prevention of adrenal insufficiency

The patient with an adrenal hyperplasia is returning from surgery for an adrenalectomy. For what immediate postoperative risk should the nurse plan to monitor the patient?

rapid Bp changes

A 50-year-old female patient smokes, is getting a divorce, and is reporting eye problems. On assessment of this patient, the nurse notes exophthalmos. What other abnormal assessments should the nurse expect to find in this patient?

systolic HTN and increased HR

596. The nurse is caring for a client with pheochromocytoma who is scheduled for adrenalectomy. In the preoperative period, what should the nurse monitor as the priority?

vital signs

Common nonspecific manifestations that may show nurse pt has endocrine dysfx is..

weight loss, fatigue, depression

587. The nurse is caring for a postoperative parathyroidectomy client. Which client complaint would indicate that a life-threatening complication may be developing, requiring notification of the health care provider immediately?

1.Laryngeal stridor

597. The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which symptoms are associated with this diagnosis? Select all that apply.

1.Tremors 2.Weight loss 3.Feeling cold 4.Loss of body hair 5.Persistent lethargy 6.Puffiness of the face 3, 4, 5, 6 tremors/weight loss - hyper

583. A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially?

2. maintain patent airway The initial nursing action would be to maintain a patent airway. Oxygen would be administered, followed by fluid replacement, keeping the client warm, monitoring vital signs, and administering thyroid hormones by the intravenous route.

594. The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood?

2."I should eat foods that have a lot of potassium in them." A diet low in carbohydrates and sodium but ample in protein and potassium is encouraged for a client with Cushing's syndrome. Such a diet promotes weight loss, reduction of edema and hypertension, control of hypokalemia, and rebuilding of wasted tissue.

586. The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder?

2.Polyuria Hypercalcemia is the hallmark of hyperparathyroidism. Elevated serum calcium levels produce osmotic diuresis and thus polyuria. This diuresis leads to dehydration (weight loss rather than weight gain).

581. The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action?

2.Test the drainage for glucose.

571. A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription?

3.Intravenous infusion of normal saline

582. After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse performs an assessment on the client, knowing that which symptom is most indicative of this disorder?

3.Polydipsia Diabetes insipidus is characterized by hyposecretion of antidiuretic hormone, and the kidney tubules fail to reabsorb water. Polydipsia and polyuria are classic symptoms of diabetes insipidus. The urine is pale, and the specific gravity is low. Anorexia and weight loss occur

598. A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?

3.Respiratory distress

591. The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder?

4."Cushing's disease results from an increased pituitary secretion of adrenocorticotropic hormone." Cushing's disease is a metabolic disorder characterized by abnormally increased secretion (endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) secreted by the pituitary gland. Addison's disease is characterized by the hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids) from the adrenal gland, resulting in deficiency of the corticosteroid hormones.

590. The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder?

4.A heart rate that is 90 beats/minute and irregular The complications associated with pheochromocytoma include hypertensive retinopathy and nephropathy, myocarditis, increased platelet aggregation, and stroke.

588. A client is diagnosed with pheochromocytoma. The nurse understands that pheochromocytoma is a condition that has which characteristic?

4.Causes the release of excessive amounts of catecholamines Pheochromocytoma is a catecholamine-producing tumor and causes secretion of excessive amounts of epinephrine and norepinephrine. Hypertension is the principal manifestation, and the client has episodes of high blood pressure accompanied by pounding headaches. The excessive release of catecholamine also results in excessive conversion of glycogen into glucose in the liver. Consequently, hyperglycemia and glucosuria occur during attacks. Pheochromocytoma is curable. The primary treatment is surgical removal of one or both of the adrenal glands, depending on whether the tumor is unilateral or bilateral.

A patient with a severe pounding headache has been diagnosed with hypertension. However, the hypertension is not responding to traditional treatment. What should the nurse expect as the next step in management of this patient?

A 24-hour urine collection for fractionated metanephrines Correct