Endocrine CH 52

The nurse administers lactulose to a client with cirrhosis. What is the expected outcome from the administration of the lactulose?

Reduced serum ammonia levels

When teaching a client when to take glipizide in order to maximize the effectiveness of the drug, the nurse should instruct the client to:

Take glipizide 30 minutes before breakfast.

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?

The isophane (NPH) insulin is peaking and causing hypoglycemia

An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of:

myxedema coma

A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:

profound neuromuscular irritability.

A nurse should expect a client with hypothyroidism to report:

puffiness of the face and hands.

A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

sodium and potassium abnormalities.

When caring for a client with diabetes insipidus, the nurse expects to administer

vasopressin (Pitressin).

A nurse should expect to administer which medication to a client with gout?

Colchicine

What is the most common cause of hyperaldosteronism?

An adrenal adenoma

Which of the following should the nurse include in the teaching plan of a female client with bilateral adrenalectomy

Emphasizing that the client will need steroid replacement for the rest of her life

A client with diabetes who takes insulin and has a low blood glucose level is being seen by the nurse. Which of the following would be the appropriate choices to begin to raise the blood glucose level? Select all that apply.

One-half cup of orange juice. • One cup of milk. • One piece of bread. • One-half cup of regular soda.

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?

An irregular apical pulse

During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently?

Assess vital signs.

The nurse is providing dietary teaching for a client with diabetes. Which of the following statements about the diet would be accurate?

It is planned around a wide variety of commonly available foods

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan?

Maintain a moderate exercise program.

Bone resorption is a possible complication of Cushing's disease. Which of the following interventions should the nurse recommend to help the client prevent this complication?

Maintain a regular program of weight-bearing exercise

When discussing recent onset of feelings of sadness and depression in a client with hypothyroidism, the nurse should inform the client that these feelings are

Most likely related to low thyroid hormone levels and will improve with treatment.

A client with insulin dependent diabetes develops a seizure disorder and has been prescribed phenytoin (Dilantin). Which of the following information should the nurse include in the teaching plan? Select all that apply

Report changes in blood glucose levels to the health care provider. • The client should use a soft toothbrush and floss his teeth daily

A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolbutamide. Which laboratory test is the most important for confirming this disorder?

Serum osmolarity

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?

Serum potassium level of 5.8 mEq/L (5.8 mmol/L)

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin?

They increase the need for insulin

A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering

vasopressin (Pitressin

Because of steroid excess after a bilateral adrenalectomy, the nurse should assess the client for:

Delayed wound healing.

A nurse should perform which intervention for a client with Cushing's syndrome?

Explain that the client's physical changes are a result of excessive corticosteroid

The nurse should teach the diabetic client that which of the following is the most common symptom of hypoglycemia

Nervousness.