Foundations II Final Exam ENDOCRINE

A 42-year-old man with a history of pheochromocytoma is being treated in the intensive care unit after experiencing an acute exacerbation of his condition. This patient will require the nurse to perform which of the following assessments most frequently?

blood pressure and heart rate

A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:

calcium gluconate

Diagnostic evaluations

-anterior pituitary gland tests -posterior pituitary gland tests -thyroid gland tests -parathyroid tests -adrenal medulla tests -adrenal cortex tests

SIADH

-cant excrete diluted urine which leads to hyponatremua -closely monitor fluid I & O, daily weight, urine, neurologic status

Cushing syndrome

-high levels of serum cortisol -obesity, musculoskeletal changes, glucose intolerance

Hypothyroidism management

-levothyroxine -monitor vital sings and cognitive level

thyroid crisis

A sudden increase in the output of thyroxine and resultant extreme elevation of all body processes (HR< BP, Temp)

Which of the following hormones controls secretion of adrenal androgens?

ACTH

cretinism

Iodine deficit/hypothyroidism

A client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood?

Pineal gland, melatonin

A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of:

Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.

Parathyroid hormone (PTH) has which effects on the kidney?

Stimulation of calcium reabsorption and phosphate excretion

A client is being screened for a thyroid disorder. The nurse would anticipate that the client would most likely undergo which test?

TSH

pituitary gland

The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands.

Pheochromocytoma

a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine -closely monitor vital signs, mental status, blood glucose and electrolyte levels

Primary aldosteronism

a condition in which the adrenal glands produce too much aldosterone because of hyperplasia or tumor

A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by:

a corticotropin-secreting pituitary adenoma.

myxedema

caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism

Manifestations of PEDS hypofunction

cold intolerance, lethargy, bradycardia, hypothermia

congenital hypothyroidism

condition of thyroid hormone deficiency present at birth

what medications would a patient require to help with adrenal insufficency?

corticosteroids

Hypo secretion of ADH results in

diabetes insipidus

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?

enlarged clitoris

The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism?

enlarged tongue

A nurse is assessing a client experiencing a severe anxiety attack. The nurse understands that the client's physiologic response to the unknown fear involves secretion of which hormone?

epinephrine

The adrenal medulla produces

epinephrine and nirepinephrine

hirsutism

excessive hair growth

hyperparathyroidism

excessive production of parathormone -surgical removal of abnormal parathyroid tissue) -hypercalcemic crisis

what would you administer for a client with SIADH?

furosemide

alpha cells of the pancreas secrete

glucagon

A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress?

glucorticosteroids

The adrenal cortex produces

glucorticosteroids, mineralcorticosteroids, and sex hormones

what would happen is congenital hypothyroidism was left untreated for several months after birth?

growth failure and permanent intellectual damage

The nurse is assessing a 4-year-old girl with ambiguous genitalia. Which finding suggests congenital adrenal hyperplasia?

hirsutism and pubic hair

A client is diagnosed with pheochromocytoma. When reviewing the client's history and physical exam, which finding would the nurse most likely note? Select all that apply.

hypertension and tachycardia

Beta cella of the pancreas secrete

insulin

One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is:

kidney stones due to overproduction of calcium

The most common type of goiter is caused by lack of which of the following?

lack of iodine

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?

low T4 level and high TSH

Hypocalcemia is associated with which of the following manifestations?

muscle twitching

Parathyroid glands produce

parathormone which causes osteoclast growth and bone resorption

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?

pituitary disorder

A nurse caring for a hospitalized patient with hypoparathyroidism reviews his electrocardiogram (ECG) strip and completes a cardiac assessment. The nurse recognizes the diagnostic sign of:

prolonged QT interval

The nurse is assessing a 5-year-old child whose parent reports the child has been vomiting lately, has no appetite, and has had an extreme thirst. Laboratory work for diabetes mellitus is being completed. Which symptom would differentiate between type 1 diabetes mellitus from type 2 diabetes mellitus?

recent weight loss

What do thyroid hormones do?

regulate metabolism

delta cells of the pancreas secrete

somatostatin

Hyper secretion of ADH results in

syndrome of inappropriate ADH (SIADH)

adverse effect of levothyroxine

tachycardia

Hypo secretion causes

the thyroid gland, adrenal cortex, and gonads to atrophy

What does the thyroid gland produce?

thyroxine (T4) and triiodothyronine (T3)

thyrotoxic crisis

toxic condition characterized by hyperthermia, tachycardia, nervous symptoms, and rapid metabolism; also known as thyroid storm.

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

vasopressin

Most common cause of hypothyroidism

autoimmune thyroiditis (Hashimoto disease)

Hypoparathyroidism

deficient production of parathyroid hormone (hypocalcemia and hyperphosphatemia) -TETANY -goal is to increase serum calcium to 9-10

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?

fluid deprivation test

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?

fluid replacement

Neurogenic diabetes insipidus

results from damafe to the posterior pituitary gland

A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?

acromegaly

Calcitonin

Lowers blood calcium levels by increasing its deposition in bone

ADH deficiency AE

excessive thirst (polydipsia), and large volumes of dilute urine

acute addisonian crisis

-Brought on by physical or psychological stress or inadequate steroid replacement -Assessment reveals: •Nausea and vomiting •Abdominal pain •Fever •Extreme weakness •Severe hypoglycemia + hyponatremia, hyperkalemia •Rapidly developing dehydration •Hypotension leading to shock and death Treatment/Intervention: -Evaluate ABC's q10-15 min -Rapid infusion of saline and 5% dextrose (Increase BP) -IV dexamethasome or hydrocorticone sodium succiate (replacement glucocorticoid) -Administer vasopressors (Increase BO) -Hemodynamic monitoring -Can lead to vascular collapse and death if untreated

Hyperthyroidism interventions

-improve nutritional status -improves coping ability and self esteem -maintenance of normal body temp

Physical examination of patient why endocrine dysfunction

-many disorders cause changes in appearance -vital sign changes common -thyroid gland should be inspected and palpated -assess eyes and vision

promoting growth for a child with congenital hypothyrodism

-measure thyroid levels ever 2-4weeks -obtain tests ever 3-4 months for first several years -every 6-12 after that

Thyroid cancer

-often accompanied by goiter -airway maintenance, pain management, fluid balance -monitor for hemorrhage, hematoma, hypocalcemia

A nurse is teaching a client about hormones within the endocrine system. Which hormones would be included as the hypothalamic hormones? Select all that apply.

-thyrotropin releasing hormone -corticotropin releasing hormone -gonadotropin releasing hormone

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?

myxedema coma

Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome?

observe stool color

Addison's disease

occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone -muscle weakness, anorexia, GI symptoms, fatigue, skin changes, hypotension, low BG, hyperkalemia, hyponatremia

A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

restricting fluids

nephrogenic diabetes insipidus

results from drug related damage to the renal tubules

psychogenic diabetes insipidus

results from excessive water intake

Diabetes insidious treatment management

-replace ADH -adequate fluid replacement -monitor patients weight -vasopressin -monitor vital signs -monitor I & O

The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid?

dairy products

primary aldosteronism results in

hypokalemia and alkalosis

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.

hypothermia, hypotension, hypoventilation