Endocrine

You must feel v sick and frightened

A client experiencing thyrotoxic crisis tells the nurse, "I know I'm going to die. I'm very sick." Which is the best response by the nurse?

Pt followed treatment regimen (normal = 4.4-6.4)

A client has a glycosylated hemoglobin measurement of 6%. What should the nurse conclude about this client when planning teaching strategies based on the results of this laboratory test?

speak

A client has a thyroidectomy for cancer of the thyroid. When evaluating for nerve injury, what should the client be asked to do?

Adrenal cortex

A client is admitted for hypertension, and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What gland is affected in aldosteronoma?

Palpitations, diaphoresis, slurred speech

A nurse is assessing a client with a diagnosis of hypoglycemia. What clinical manifestations support this diagnosis? Select all that apply.

Seizures

A nurse is assessing a client with a suspected pituitary tumor. Which assessment finding is consistent with a pituitary tumor?

Maintain a patent airway

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

Muscle weakness and frequent urination

A client is admitted to the hospital with a diagnosis of Cushing syndrome. What signs and symptoms will the client most likely exhibit?

sudden massive hemorrhage

Because of multiple physical injuries and emotional concerns, a hospitalized client is at high risk to develop a stress ulcer (Curling). Which of these is evidence of a stress ulcer?

Antidiuretic hormone

What other name can the nurse use for vasopressin?

Polyuria (Chronic hyperglycemia, resulting from poor glycemic control, contributes to the microvascular and macrovascular complications of diabetes mellitus. Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia. )

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed?

Any changes in your vision? Do you experience severe HAs? Any changes in menstrual cycle?

After assessing a client, the nurse anticipates that the client has hyperpituitarism. Which questions asked by the nurse helps confirm the diagnosis? Select all that apply.

Have the pt say what time it is

The nurse is caring for a client immediately after a subtotal thyroidectomy. How will the nurse assess for unilateral injury of the laryngeal nerve?

Lithium therapy

What does the nurse state as the etiological factor of nephrogenic diabetes insipidus (DI)?

Decreased pituitary secretion of ACTH

What expected effect of increased serum cortisone levels does a nurse consider when caring for clients with multiple physical and emotional problems?

Adrenal adenoma

What is the most probable cause for Conn's syndrome in an adult client?

Support the head when changing position

A client is scheduled to have a thyroidectomy for thyroid cancer. What specific instruction about postoperative care should the nurse provide the client during preoperative teaching?

Cortisol

While reviewing the laboratory reports of a client, the nurse finds that the client has low sodium levels. Which hormonal imbalance should the nurse suspect in the client?

Muscle spasms

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery?

Hypotension

A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication?

It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.

An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?

Hyperpigmentation

A nurse is caring for a client with Addison's disease. Upon assessment, which classic sign will the nurse find?

Levothyroxine

A client complains of fatigue, hair loss, and weight gain. On assessment, the client is found to have anemia. Which therapy does the nurse anticipate in the client's prescription?

Octreotide

A client complains of joint pain with deformities. On assessing the client, the nurse suspects that the client has acromegaly. Which medication is beneficial to the client?

Cool skin, constipation, periorbital edema, decreased appetite

A nurse is assessing a client with hypothyroidism. Which clinical manifestations should the nurse expect the client to exhibit? Select all that apply.

Diminished axillary hair

A nurse is assessing the skin of a client with a cortisol deficiency. Which integumentary assessment finding will most likely be observed in this client?

Increase fluid intake (prevents renal calculi)

A nurse is caring for a client admitted to the hospital with primary hyperparathyroidism. Which action should be included in this client's plan of care?

Admin glucagon, IV glucose, and oral hydrocortisone

A nurse is caring for a client with hypoglycemia. Which nursing intervention would be appropriate in managing the client's condition? Select all that apply.

Schedule appointment (Anemia?)

A primary healthcare provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. Two months after being started on the antithyroid medication, the client calls the nurse and complains of feeling tired and looking pale. What should the nurse do?

Metabolic acidosis

During the progressive stage of shock, anaerobic metabolism occurs. Which complication should the nurse anticipate in this client?

Tetany

During thyroid surgery, a client's parathyroid glands have become damaged. Which condition does the nurse expect the client to develop?

Gastric ulcer, pain in bones, muscle weakness

The nurse is assessing a client with a "moon-shaped" face and thinner arms and legs. Which other assessment findings would the nurse suspect to be present in this client? Select all that apply.

Regularly monitor BP (may cause HTN and sodium retention)

The primary health care provider prescribes fludrocortisone to a client with adrenal gland hypofunction. What does the nurse instruct the client about this medication?

Low dose should be given when initiating therapy

The registered nurse is teaching the student nurse how to care for a client with hyperpituitarism who is being treated with bromocriptine mesylate. Which statement made by the student nurse indicates effective learning?

Weight loss, exophthalmos, and restlessness

What symptoms will the nurse identify when assessing a client with Graves disease?

Urine negative for ketones and positive glucose in the blood

When assessing the laboratory values of a client with type 2 diabetes, what would the nurse expect the results to reveal?

Admin at night

Which action by the nurse while administering human growth hormone ensures effective therapy?

Parafollicular cells

Which cells does the nurse identify as producing thyrocalcitonin hormone?

diarrhea + weight loss

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply.

Hypotension

Which clinical manifestation occurs in a client with vasopressin deficiency?

Pituitary tumors

Which does the nurse state is a secondary cause of adrenal insufficiency?

Clomiphene

Which drug will the nurse administer to trigger ovulation?

Minimal tape on skin

Which intervention should the nurse provide while caring for an older adult client who is reported to have decreased estrogen production?

Admin fluid replacement

Which nursing intervention is the priority when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

changes in chest shape, lip thickness, hand length

While reviewing the client's laboratory reports, the nurse finds that there is an elevation in the client's growth hormone levels. Which key features does the nurse assess to rule out the occurrence of acromegaly? Select all that apply.

monitor BP (causes HTN)

A client diagnosed with adrenal gland hypofunction is receiving fludrocortisone therapy. Which nursing intervention would help the client reduce the risk of complications?

Tetany

A nurse is caring for a client who had a thyroidectomy. Which client response should the nurse assess when concerned about an accidental removal of the parathyroid glands during surgery?

All urine should be saved and refrigerated during the 24 hours of the test. Toilet paper or feces should not contaminate the specimen. These nutrients, in addition to mints, bananas, vanilla, and tea, increase the VMA level and should be avoided three days before and during the test. Chlorpromazine causes an elevation in the VMA level and should be avoided during the test. Therefore, the primary healthcare provider should be consulted. The client should rest and avoid physical activity during the test because activity increases VMA levels. Salicylates increase VMA levels and should be avoided during the test.

A nurse is caring for a client with a tentative diagnosis of pheochromocytoma who is receiving chlorpromazine. A 24-hour urine specimen to assess the presence of vanillylmandelic acid (VMA) is prescribed to assist in confirmation of the diagnosis. What information should the nurse include in the client teaching regarding this test? Select all that apply.

Use 1/3-1/2 dose

A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client?

Complications not present at time of dx

A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes, and the other client has type 2 diabetes. When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1?

Report personality changes (ammonia is toxic to CNS)

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan?

126-140

A nurse is monitoring a client's laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic?

"I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2 mmol/L)."

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement?

I will procure a flu vaccine yearly, visit the hospital frequently for lifelong hormonal therapy, and immediately notify the HCP if i have a fever

The nurse is teaching a client who underwent bilateral adrenalectomy about self-management after discharge. Which statements given by the client indicate effective learning? Select all that apply.

thirst, fruity breath odor, increase urination

The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? Select all that apply.

Initiate infusion of 3% NaCl, restrict fluids to 800 mL over 24 hrs, administer vasopressin antagonist

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply.

Emotional liability, hyperactive DTRs, dyspnea on exertion

The nurse is assessing a client with hyperthyroidism. Which clinical indicators are consistent with this diagnosis? Select all that apply.

Increased temp and pulse rate

The nurse is caring for a client who had a thyroidectomy. Which symptoms will the client exhibit if having a thyrotoxic crisis?

Shakiness, palpitations, lightheadedness

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply.

Test the drainage for glucose

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?

Urine output 3 L/day (to decrease UO in diabetes insipidus)

The nurse is caring for a client who is prescribed desmopressin acetate. What is the expected outcome in the client?

Intracellular to intravascular because of hyperosmolarity

The nurse is caring for a client with diabetes mellitus. What is the primary fluid shift that occurs with this condition?

dress warmly in cold (cold intolerance)

The nurse is caring for a client with hypothyroidism. Which instruction is most important to provide to the client to help in managing their condition?

Indomethacin

The nurse is caring for a client with nephrogenic diabetes insipidus who is prescribed a low-sodium diet and chlorothiazide therapy. The client fails to respond to the therapy. Which alternative treatment should the nurse be prepared to administer?

Inadequate fluid volume

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem?

Moon face

Which feature in the client indicates hypersecretion of adrenocorticotrophic hormone?

increase fiber intake

Which instruction given by the nurse ensures good healing in a client recovering after surgical removal of the pituitary gland by endoscopic transnasal approach?

IV infusion of normal saline

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

Glucose level

A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome?

7.8 mg/dL

A client is diagnosed with parathyroid dysfunction. Which serum calcium concentration in the client would support the diagnosis?

Give IV fluids containing dextrose (Emergency management of DKA focuses on correcting fluid and electrolyte imbalances and normalizing the serum glucose level. If the corrections occur too quickly, serious consequences, including hypoglycemia and cerebral edema, can occur. During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL (14.2 mmol/L), or until the client recovers from ketosis.)

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?

Assess the sides and back of the client's neck for evidence of bleeding.

A client is admitted to the hospital with a diagnosis of cancer of the thyroid gland, and a thyroidectomy is performed. What should the nurse do during the first six to eight hours after surgery?

Fats

A client is admitted to the hospital with diabetic ketoacidosis. The nurse concludes that the client's elevated ketone level is caused by incomplete oxidation of which nutrient?

evaluate urine specific gravity

A client with a brain tumor develops a urine output of 300 mL/hr, dry skin, and dry mucous membranes. Which nursing intervention is the most appropriate to perform for this client?

Comatose state, deep/rapid breathing, elevate BG level

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply.

Hypercalcemia

A client with a parathyroid disorder reports nausea, vomiting, weight loss, and epigastric pain. Which electrolyte disturbance would be responsible for the client's clinical manifestations?

Hypernatremia

A client with a tentative diagnosis of Cushing syndrome has an increased cortisol level. What response should the nurse assess this client for?

Convey empathy/trust/respect

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?

TSH + T3

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client?

Monitor BP

A client's laboratory report reveals decreased serum and salivary cortisol levels and increased serum potassium level from hypofunctioning of the adrenal gland. The client is prescribed fludrocortisone. Which nursing action in the follow-up visit minimizes risk of a potential side effect of medication?

I need to stop taking my insulin

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?

Asthma, cancer chemo, organ transplant

Which exogenous conditions are responsible for increased cortisol secretion? (AKA Cushings)