prepu endo
Blood pressure of 160/100 mm Hg
A client presents to the clinic for a follow-up visit for hospitalization due to uncontrolled diabetes. Which of the following assessment findings indicates a complication of diabetes mellitus?
myxedema coma
A client receiving thyroid replacement therapy develops influenza and forgets to take the prescribed thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing what life-threatening complication?
glycosylated hemoglobin level.
A client tells the nurse that they have been working hard for the past 3 months to control the client's type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check
Delayed wound healing
A client has had a bilateral adrenalectomy. For which potential complication should the nurse assess the client?
"I will use salt substitute to flavor my foods."
A client is diagnosed with Addison's disease. Which statement by the client to the nurse would require further instruction?
Inject 35 units air into NPH vial; inject 15 units air into regular insulin vial, withdraw 15 units regular insulin; withdraw 35 units NPH.
A client is diagnosed with diabetes mellitus. The physician orders 15 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. The nurse checks the medication order, assembles equipment, washes their hands, rotates the NPH insulin vial, puts on disposable gloves, and cleans the stoppers. To draw the two insulin doses into the single U-100 insulin syringe, which sequence should the nurse use?
restricting fluids to 800 ml/day
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH?
"I need to call my healthcare provider to discuss my steroid needs before I have dental work." "I'll call the healthcare provider if I suddenly feel profoundly weak or dizzy." "I need to obtain and wear a Medic Alert bracelet."
A client with Addison's disease is scheduled for discharge after being hospitalized for an adrenal crisis. Which statements by the client indicate that client teaching has been effective? Select all that apply.
hydrocortisone
A client with a history of Addison's disease and flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. The client's spouse reports that the client acted confused and was extremely weak upon waking that morning. The client's blood pressure is 90/58 mm Hg, pulse is 116 beats/minute, and temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?
The isophane (NPH) insulin is peaking.
A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane (NPH) insulin to be taken before breakfast. At about 4:30 p.m. (1630), the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
an occurrence of the excess loss of fluid associated with osmotic diuresis
A client with diabetic ketoacidosis (DKA) has asked the unlicensed nursing assistant for another pitcher of water. It is the third such request over the past 4 hours. The nurse would recognize this request as which manifestation?
low thyroid hormone levels and will improve with replacement therapy."
A client with hypothyroidism has started to take thyroid hormone replacement therapy and asks the nurse about the reason for feeling sad and depressed. What should the nurse tell the client? "The feelings of sadness and depression are caused by:
obtaining, reporting, and documenting fingerstick glucose levels
A group of nursing assistants hired for the medical-surgical floors are attending hospital orientation. Which topic should the educator cover when teaching the group about caring for clients with diabetes mellitus?
Test the drainage for a yellow "halo."
A nurse is caring for a client following transsphenoidal hypophysectomy and notes a watery discharge from the client's nose. Which action is appropriate for the nurse to take?
Vasopressin
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering
vasopressin.
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering
fluid deprivation test
A nurse is caring for a client with suspected diabetes insipidus. Which test does the nurse anticipate the physician will order to confirm the diagnosis?
Administer an IV bolus of 50% dextrose.
A nurse is caring for a client with type 1 diabetes who is light headed, begins sweating profusely, and loses consciousness. Which action should the nurse take?
Encircle the client's neck with both hands, have the client slightly extend their neck, and ask them to swallow.
A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate?
stimulated protein metabolism
After a bilateral adrenalectomy for Cushing's disease, the client will receive periodic testosterone injections. What is the expected outcome of these injections?
maintaining room temperature in the low-normal range
For a client with Graves' disease, which nursing intervention promotes comfort?
A 55-year-old complaining of chest pressure
On a medical-surgical floor, a nurse is caring for a cluster of clients with diabetes mellitus. Which client should the nurse assess first?
Call the health care provider (HCP) for specific prescriptions based on the glucose level.
On the day of surgery, a client with diabetes who takes insulin on a sliding scale is to have nothing by mouth and all medications withheld. The client's 0600 glucose level is 300 mg/dL (16.7 mmol/L). What should the nurse do?
Observe stools for steatorrhea.
The client has chronic pancreatitis. What should the nurse teach the client to do to monitor the effectiveness of pancreatic enzyme replacement?
Reduced serum ammonia levels.
The nurse administers lactulose to a client with cirrhosis. What is the expected outcome from the administration of the lactulose?
Remind the client not to smoke, drink caffeinated beverages, or change positions suddenly.
The nurse is assigned to a client with pheochromocytoma. In providing nursing care for the client, which action should the nurse delegate to the unlicensed assistive personnel (UAP)?
Assess what the client already knows to identify learning needs.
The nurse is caring for a client with type 2 diabetes who has been admitted with hyperglycemia. What is the most important consideration when developing a teaching plan for this client?
the levothyroxine before breakfast and the other medications 4 hours later.
The nurse is instructing the client with hypothyroidism who takes levothyroxine 100 mcg, digoxin, and simvastatin. The nurse judges that the teaching regarding the use of these medications is effective if the client will take:
"Take the drug on an empty stomach."
The nurse is teaching a client about levothyroxine. Which instruction should a nurse offer the client?
daily neck exercises
The nurse is teaching a client scheduled for thyroid lobectomy. What information will the nurse include?
"Tight control of blood sugar and blood pressure can prevent damage to my eye."
The nurse teaches a client with type 2 diabetes mellitus about diabetic retinopathy. Which statement if made by the client would indicate to the nurse that teaching was effective?
myxedema coma Maintain intake and output records. Document presenting signs and symptoms.
The physician has prescribed sodium chloride for a hospitalized 51-year-old client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply.
tell the health care provider the client isn't comfortable consenting to surgery at this point.
When a nurse attempts to make sure the health care provider obtained informed consent for a thyroidectomy, the nurse realizes the client doesn't fully understand the surgery. The nurse approaches the physician, who curtly says, "I've told this client all about it. Just get the consent." The nurse should
pH 7.48
When evaluating a client's arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?
take glipizide 30 minutes before breakfast.
When teaching a client when to take glipizide in order to maximize the effectiveness of the drug, the nurse should instruct the client to:
using sterile technique during the dressing change
Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer?
The client is severely dehydrated and needs 2 to 3 L of I.V. fluid rapidly.
Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome?
maintain normal fluid and electrolyte balance.
Which statement indicates that the client with diabetes insipidus understands how to manage care?