Unit 11 neuro

During an assessment of a client's functional health pattern, which question by the nurse directly addresses the client's thyroid function? "Do you have to get up at night to empty your bladder?" "Have you experienced any headaches or sinus problems?" "Do you experience fatigue even if you have slept a long time?" "Can you describe the amount of stress in your life?"

"Do you experience fatigue even if you have slept a long time?"

A client with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the client should prioritize what question when addressing potential complications? "Do you feel any muscle twitches or spasms?" "Do you feel flushed or sweaty?" "Are you experiencing any dizziness or lightheadedness?" "Are you having any pain that seems to be radiating from your bones?"

"Do you feel any muscle twitches or spasms?"

A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? "Have you had a recent head injury?" "Has your shoe size increased recently?" "Do you experience skin breakouts?" "Is there any family history of acromegaly?"

"Has your shoe size increased recently?"

A nurse is caring for a client suspected of having a pituitary tumor that is causing panhypopituitarism. During assessment of the client, which clinical manifestation would the nurse expect to find? Atrophy of the gonads Carpopedal spasm Hypertension Tachycardia

Atrophy of the gonads a condition of inadequate or absent production of the anterior pituitary hormones

The nurse is caring for a client with Addison disease who is scheduled for discharge. When teaching the client about hormone replacement therapy, the nurse should address what topic? The possibility of precipitous weight gain The need for lifelong steroid replacement The need to match the daily steroid dose to immediate symptoms The importance of monitoring liver function

The need for lifelong steroid replacement

If you had older client with hearing loss, what are five nursing interventions you would do for him?

Turn off the tv or radio, background noise makes it difficult to distinguish different sounds. Simply speak clearly and slow down so you pronounce your words separately. clearly will resolve this problem. Plan for sick times such as procedures and surgeries when interpreters are needed or when hearing aids cannot be worn. Remember, there is a difference between hard of hearing and deaf culture and their needs.

If you had older client with vision loss, what are five nursing interventions you would do for him?

Use teaching aids with black print font size 22 or larger on ivory background it minimizes glare. Indirect lightning over the shoulder helps with glare. Assess for color perception. Older adults experience yellowing of the lens. Make sure they understand if they have different color pills.

Ask client to wrinkle the forehead, smile, frown, raise eyebrows, look at ceiling, and whistle. Instruct client to close eyelids and resist examiner's efforts to open them. Apply sweet, sour, salty, and bitter flavors to both sides of the anterior tongue.

VII—Facial

Which hormone is secreted by the posterior pituitary? Vasopressin Calcitonin Corticosteroids Somatostatin

Vasopressin

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone? increase serum calcium level inhibit release of calcium into extracellular fluid decrease serum calcium level promote urinary secretion of calcium

increase serum calcium level

substances that form when the body breaks down male steroid hormones (androgen) and other hormone released by adrenal glands in males and females , and by testes in males

17-ketosteroids

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands? four three two one

4

normal fasting blood glucose less than 70 mg/dL greater than or equal to 140 glucose level diabetes

70-110 mg/dL hypoglycemia diabetes

The nurse is providing care for an older adult client whose current medication regimen includes levothyroxine. As a result, the nurse should be aware of the heightened risk of adverse effects when administering an IV dose of what medication? A fluoroquinolone antibiotic A loop diuretic A proton pump inhibitor (PPI) A benzodiazepine

A benzodiazepine

Iodine's role

Body must have iodine to make thyroid T3 and T4Insufficient causes goitersT4 contains 4 iodine atoms and secreted abundantly T3 contains 3 atoms of iodine Both regulate metabolism, and G&D

When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted: Thyroxine Phosphorus Parathyroid Calcitonin

Calcitonin

A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client? Increased body temperature Jaundice Copious urine output Decreased blood pressure

Decreased blood pressure

If hearing loss is noticed by your assessment, how do you tell the doctor? Write out exactly step by step what you would tell the doctor?

Describe to the MD the child would not speak.. points to things, ignores things that should be of interest, does not startle to loud noises or cry

affects carb, fat and protein metabolism

Diabetes Mellitus

A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate? Have the client flex his neck onto his chest and cough while she palpates the anterior neck with her fingertips. Place her hands around the client's neck, with the thumbs in the front of the neck, and gently massage the anterior neck. Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow. Have the client hyperextend his neck and take slow, deep inhalations while she palpates his neck with her fingertips.

Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.

Following an addisonian crisis, a client's adrenal function has been gradually regained. The nurse should ensure that the client knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? Episodes of high psychosocial stress Periods of dehydration Episodes of physical exertion Administration of a vaccine

Episodes of high psychosocial stress

The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto thyroiditis. When assessing this client, what sign or symptom would the nurse expect? Fatigue Bulging eyes Palpitations Flushed skin

Fatigue

The adrenal cortex is responsible for producing which substances? Glucocorticoids and androgens Catecholamines and epinephrine Mineralocorticoids and catecholamines Norepinephrine and epinephrine

Glucocorticoids and androgens

A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding? Glucose in the urine Albumin in the urine Highly dilute urine Leukocytes in the urine

Highly dilute urine produce large amounts of urine; ADH insufficient

While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the client's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see? Hyperthermia and tachypnea Hypertension and heart rate changes Hypotension and hypothermia Hyperthermia and bradycardia

Hypertension and heart rate changes

The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? Headache Hypotension Diaphoresis Palpitations

Hypotension

In a darkened room, shine a bright light in each pupil; ask client to look at a near and far object

III—Oculomotor

Client and examiner cover an eye, and examiner moves an object from the periphery toward client's nose from superior, inferior, medial, and lateral positions while both fix their gaze straight ahead. Examiner then tests opposite eye.

II—Optic

The nurse's assessment of a client with thyroidectomy suggests tetany and a review of the most recent blood work corroborates this finding. The nurse should prepare to administer what intervention? Oral calcium chloride and vitamin D IV calcium gluconate STAT levothyroxine Administration of parathyroid hormone (PTH)

IV calcium gluconate

See assessment for motor function of oculomotor nerve.

IV—Trochlear

Touch palate with a tongue blade. Ask client to say "ah."

IX—Glossopharyngeal

A client newly diagnosed with diabetes is discussing the disease with the nurse. The client asks about the hormones that might affect diabetes. Which is considered client teaching information about somatostatin? It releases cortisol to help with stress. It stimulates the release of a hormone. It inhibits the release of insulin. It stimulates the breakdown of fats and proteins.

It inhibits the release of insulin.

The negative feedback system along the HPA may include a secondary dimension. Current thought is that the anterior pituitary may be sensitive to TSH levels as well as thyroid hormone. What does this regulate in the body? The production of parathyroid hormone Its own production of TSH The conversion of parathyroid hormone into thyroid hormone Its own production of thyroid hormone

Its own production of TSH

How are you going to communicate with this child who is blind?

Make sure instructions are enlarged for her to read. You may have to touch her hand or shoulder to let her know you are close by.

The pharmacology instructor is discussing the endocrine system with a class of pre-nursing students. What would the instructor tell the students is considered to be a hormone? Norepinephrine Acetylcholine Nucleic acid Serotonin

Norepinephrine

diet high in carbs eaten over 3 days. Client fasts for 8 hours, urine specimen is collected

Oral glucose tolerance test

A nurse is attending a client in labor and is monitoring the duration and frequency of her uterine contractions. The client asks the nurse how the body knows how to give birth. Which hormone intensifies the contractions of the uterus and enables the uterus to push out the fetus? Prolactin Melanocyte Oxytocin Insulin

Oxytocin

Large fish shaped organ behind and inferior tot he stomach and liver which is both exocrine and endocrine.

PANCREAS

How do you assess the child's vision? What are some nursing interventions you could do to assess vision loss?

Place objects close by so she can grab them. Place call bell in her hand or make her aware where it is located. Does she use a walking stick or cane.

A client who is being tested for syndrome of inappropriate antidiuretic hormone secretion asks the nurse to explain the diagnosis. While explaining, the nurse states that excessive antidiuretic hormone is secreted from which gland? Anterior pituitary Posterior pituitary Adrenal Thyroid

Posterior pituitary LOOK AT FLASHCARDS

A client with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the client, the nurse should know that the client's diminished thyroid function may have what effect? Anaphylaxis Nausea and vomiting Increased risk of drug interactions Prolonged duration of effect

Prolonged duration of effect

What are the tests you can perform on this child to detect hearing loss?

Rinne and Weber tests

A client with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the client. Which is an appropriate nursing diagnosis? Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns Insomnia related to increased nighttime voiding Impaired nutrition: more than body requirements related to polyphagia Activity intolerance related to muscle cramps, cardiac dysrhythmias, and weakness

Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns

How are you going to communicate with this child? What is your non-verbal communication going to be? Be specific.

Sit down, on their level, don't be a stranger, face to face, use short sentences,

Parathyroid hormone (PTH) has which effects on the kidney? Stimulation of calcium reabsorption and phosphate excretion Stimulation of phosphate reabsorption and calcium excretion Increased absorption of vitamin D and excretion of vitamin E Increased absorption of vitamin E and excretion of vitamin D

Stimulation of phosphate reabsorption and calcium excretion

A client with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in the client's cortisol levels. How should the nurse interpret this finding? The client's pituitary function is compromised. The client's adrenal insufficiency is not treatable. The client has insufficient hypothalamic function. The client would benefit from surgery.

The client's pituitary function is compromised.

A group of nursing students are doing a presentation on hormones. What hormone would the presentation show regulates the metabolic rate and influences the growth and development of the body? PTH or parathormone Thyroid hormone Cortisol Insulin

Thyroid hormone

Test hearing acuity and perform the Rinne and Weber tests with a tuning fork Have client stand with both feet close together; note for swaying with eyes open and then shut.

VIII—Vestibulocochlear

Observe for jaw symmetry while client opens mouth. Instruct client to clamp jaws tightly together.

V—Trigeminal

thick velvety patches found in the fold of skin

acanthosis nigricans

A nurse working in the ED at a level 1 trauma center is notified that casualties from a multivehicle car accident are currently in transit. The nurse's heart is pounding and mouth is dry. What gland is responsible for this nurse's physiologic response? adrenal medulla thyroid gland adrenal cortex pineal gland

adrenal medulla

controls hormone levelsTurns hormones on and off to keep hormones in normal levelMost endocrine disorders result from over\under production of hormones

biological feedback loop

Which diagnostic test is done to determine suspected pituitary tumor? computed tomography scan measurement of blood hormone levels radioimmunoassay radiographs of the abdomen

computed tomography scan

During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? decrease in hormonal levels increase in hormonal levels hormonal overproduction hormonal underproduction

decrease in hormonal levels

normal level < 5.7, pre-diabetic 5.7- 6.4, diabetic >6.5

hemoglobin A1C

Fruity breath should make you think of what diagnosis?

hyperglycemia

primary function is homeostasis

hypothalamus

thyrotropin, corticotropin, gonadotropin, growth-hormone

hypothalamus hormones

breaks down fat. accumulation of fatty acids and ketones

lipolysis

Cardiac effects of hyperthyroidism include decreased pulse pressure. decreased systolic BP. bradycardia. palpitations.

palpitations.

Which organ is both an exocrine and an endocrine gland? pancreas ovaries pineal gland thymus gland

pancreas

Embedded within the lateral lobes of the thyroid. There are 2 upper glands and 2 lower glands

parathyroid

glucose taken 2 hours after a high carb meal( 80-160)

postprandial

difficulty with coordination, double vision, unconsciousness, and seizures

rule out hypoglycemia or DKA

What are the tests you can perform on this child to detect vision loss?

snellen eye chart

bone and muscle growth and fat metabolism

somatrotropin

What does the thymic humoral factor increases?

the immune response to viruses

A client with a traumatic brain injury is producing an abnormally large volume of dilute urine. Which alteration to a hormone secreted by the posterior pituitary would the nurse expect to find? Deficient production of vasopressin Increased antidiuretic hormone Increased oxytocin A deficient amount of somatostatin

Deficient production of vasopressin

A client with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the client to improve the patient's nutritional intake. What foods should a client with Cushing syndrome eat to optimize health? Select all that apply. Foods high in vitamin D Foods high in calories Foods high in protein Foods high in calcium Foods high in sodium

Foods high in vitamin D Foods high in protein Foods high in calcium

Ask client to occlude each nostril separately and close the eyes. Present familiar odors, such as vinegar, lemon, coffee, and ammonia.

I—Olfactory

Secreted by the Thymus gland and aids in T-lymphocytes, a type of white blood cell involved in immunity.

Thymosin and Thymopoietin

The physiology instructor is discussing negative feedback systems in endocrine activity. What would be the instructor's best explanation of the purpose of the negative feedback system in endocrine activity? To change the environment of the pituitary gland To regulate hormone release To maintain hormone concentration at a certain level To control the action of hormones

To maintain hormone concentration at a certain level

How do you assess the child's hearing? What are some nursing interventions you could do to assess hearing loss? How do you know if a child is deaf

Try to talk with the child, sit at their level, play with them - the child should be able to talk clearly at a three speak some words. How do you know if a child is deaf - points at things, does not track sound, does not startle to noise, speech delays (does not babble etc. like other children).

See assessment for motor function of oculomotor nerve.

VI—Abducens

Tell client to stick out the tongue.

XII—Hypoglossal

Instruct client to shrug the shoulders as you apply resistance.

XI—Spinal accessory

Have client say "la, la, la."

X—Vagus

increases calcium in the blood by releasing calcium and phosphorus from the bones. Interfers with urine excretion of calcium and activates vitamin D (causes increase of calcium absorption)

function of parathyroid

This gland is large during childhood but usually shrinks by adulthood.

thymus gland