NUR 212 EAQ - Chapter 49: Endocrine Problems

Which instructions would the nurse provide to a patient undergoing radioactive iodine therapy in the outpatient setting? Select all that apply.

-Avoid preparing food for others. -Launder personal towels, bed linens, and clothes separately at home. -Avoid being close to pregnant women or children for seven days after therapy.

Which syndrome would be suspected in a patient who has Addison's disease along with other endocrine conditions?

Autoimmune polyglandular syndrome.

A patient with a goiter mentions losing 60 pounds in three months on a "raw food diet." Which foods, if eaten in great excess, would the nurse suspect as the cause of the goiter?

Broccoli.

For a patient who presents with an enlarged thyroid gland but has normal thyroid levels, which type of goiter would be documented in the patient's medical record?

Nontoxic.

Which cause is associated with central diabetes insipidus?

The presence of a brain tumor.

Which instruction would the nurse teach a patient with Addison's disease about corticosteroid therapy?

"Do not stop taking the medication abruptly."

The nurse is performing discharge education for a patient newly diagnosed with hypothyroidism and is beginning thyroid hormone therapy. Which statement by the patient to the nurse confirms that discharge teaching was effective?

"I should take my levothyroxine every morning before eating my breakfast."

The registered nurse is teaching a student nurse about assessing a patient with Cushing syndrome who is on corticosteroid therapy. Which statement made by the student nurse about assessment would need correction?

"I will assess for postural changes."

The nurse teaches a patient about radioactive iodine (RAI) therapy for the treatment of hyperthyroidism. Which statement made by the patient indicates a need for further instruction?

"I will need to take antithyroid drugs for six to nine months after I begin RAI therapy."

Which patient statement indicates the need for further education regarding the management of both cardiac disease and hypothyroidism?

"I will use an enema for constipation."

A patient diagnosed with hyperthyroidism received radioactive iodine one week ago. The patient tells the nurse, "I don't think the medication is working. I don't feel any different." Which is the best response by the nurse?

"It may take several weeks to see the full benefits of the treatment."

What instruction would the nurse include in the teaching plan for a patient who is receiving radioactive iodine (RAI)?

"Towels that are used by you should not be used by other family members."

A patient diagnosed with acromegaly has developed speech difficulties and asks what is causing the problem. Which response by the nurse is accurate?

"You have developed the condition due to overgrowth of the tongue."

The nurse is teaching a patient about diagnostic tests for Cushing syndrome. Which statements by the nurse would be accurate regarding the tests to confirm the diagnosis? Select all that apply.

"You will have your plasma adrenocorticotropic hormone (ACTH) levels checked." "Collect a 24-hour urine sample for testing free cortisol and 17-ketosteroids." "Undergo computed tomography (CT) scan or magnetic resonance imaging (MRI.)"

Which findings in a patient diagnosed with acromegaly would require the nurse to prepare the patient for surgery? Select all that apply.

-Appearance of pituitary tumors. -Increase in growth hormone (GH) concentration after oral glucose tolerance test.

Which nursing interventions would be included in the plan of care for a patient recovering from a thyroidectomy? Select all that apply.

-Assessing for tetany -Monitoring vital signs -Assessing the patient every two hours on the first postoperative day

Which symptoms of drug toxicity would the nurse teach the patient who is taking levothyroxine? Select all that apply.

-Chest pain -Nervousness -Tachycardia

Which interventions would the nurse include in the plan of care for a patient who has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH)? Select all that apply.

-Limit fluids to 1000 mL per day. -Keep the head of the bed at 10 degrees or less elevation.

Which nursing inventions would be included in the plan of care for a patient who had a parathyroidectomy? Select all that apply.

-Monitor intake and output. -Ensure that IV calcium is available. -Assess for numbness and tingling of the hands and mouth.

Which actions would the nurse take when caring for a patient status post a transsphenoidal hypophysectomy? Select all that apply.

-Monitoring the pupillary response. -Elevating the head of the patient's bed. -Observing the patient for any signs of bleeding. -Monitoring extremity strength to detect neurologic complications.

Which clinical manifestations would the nurse assess in a hospitalized patient experiencing exophthalmos? Select all that apply.

-Tachypnea -Increased appetite -Bounding, rapid pulse

To promote optimal absorption, the nurse would instruct a patient to take their levothyroxine at which time?

0600.

Which factor may be the cause of iatrogenic Addison's disease?

Adrenal hemorrhage.

The nurse would plan to teach a patient with Addison's disease about the need for which primary treatment?

Adrenocorticosteroid replacement therapy.

A nurse caring for a patient with hyperparathyroidism would monitor the patient for which complication?

Cardiac dysrhythmias.

Which food item would be included on a list of foods that fall under the category of goitrogens?

Cauliflower.

The nurse is caring for a hospitalized patient with bronze-colored skin and signs of hyperpigmentation, especially in a sun-exposed area. Which drug would the nurse plan to teach the patient about in this case?

Fludrocortisone.

Which characteristic is seen in syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

Fluid retention.

Which intervention would the nurse take for a patient with hyperaldosteronism?

Frequent BP monitoring.

A nurse completes an assessment and notes that a patient's thyroid gland is enlarged. With which condition is this finding consistent?

Goiter.

Which hormone is secreting excessively if a patient with a pituitary tumor has developed excessive height and increased hat size and shoe size?

Growth hormone (GH.)

Which effect does an increased level of plasma insulin-like growth factor-1 have on growth hormone levels?

Growth hormone levels are elevated.

Which condition may be linked to Conn's syndrome?

Hyperaldosteronism.

Which nursing action would prevent the leakage of cerebrospinal fluid (CSF) after a transsphenoidal hypophysectomy?

Instructing the patient to avoid vigorous coughing, sneezing, and straining at stool.

Which drug would be administered to control glucose levels in a patient with endogenous Cushing syndrome and who has a history of type 2 diabetes?

Mifepristone.

Which nursing intervention would be included in the plan of care for a patient who underwent a transsphenoidal hypophysectomy?

Monitor pupillary response and speech patterns.

Which nursing intervention is most important for a patient with diabetes insipidus?

Monitoring fluid intake and output.

A patient has a dysfunction of the pituitary gland. Which hormone secretion may be altered in a patient with a dysfunction of the pituitary gland?

Prolactin.

A patient reports to the nurse having visual problems and is found to have a compressed optic chiasm. Which condition could be the reason for this complication?

Prolactinomas.

A young adult female patient with normal body weight has excessive hair growth on her face, infrequent menstruation, and infertility. Which type of endocrine disorder is suspected in the patient?

Prolactinomas.

A patient has a serum sodium level of 134 mEq/L, an osmolality less than 280 mOsm/kg, and the urine specific gravity is greater than 1.025. Which medication is most beneficial for this patient?

Tolvaptan.

Which dosage schedule would be recommended for the administration of glucocorticoids?

Two thirds of a dose in the morning and one third in the afternoon.

Which test is more reliable to diagnose pheochromocytoma?

Urinary creatinine.

Which instructions would the nurse include in a dietary teaching plan provided to a patient who is diagnosed with hyperthyroidism? Select all that apply.

-Consume a high-calorie diet. -Eat snacks high in protein. -Avoid caffeinated beverages.

Which pathophysiologic events occur with syndrome of inappropriate antidiuretic hormone secretion (SIADH)? Select all that apply.

-Decreased serum osmolality -Increased water reabsorption -Occurrence of dilutional hyponatremia

Which laboratory results would confirm overt hyperthyroidism? Select all that apply.

-Elevated triiodothyronine (T3) level -Elevated free T4 level -Low TSH level

Which instruction would the nurse give the patient with hyperaldosteronism who is prescribed eplerenone?

"Avoid grapefruit juice."

Which clinical manifestations would the nurse assess in a patient with hyperthyroidism? Select all that apply.

-A positive bruit upon auscultation of the thyroid gland -A goiter -Clubbing of the fingers

Which condition can result if hypersecretion of growth hormone (GH) occurs after epiphyseal plate closure?

Acromegaly.

Which drug would the nurse plan to teach a patient about who has been diagnosed with hyperthyroidism, asthma, and heart disease?

Atenolol.

The nurse would monitor for increases in which laboratory value in a patient being treated with dexamethasone?

Blood glucose.

Which symptom would the nurse expect to see in a patient suspected of having hypothyroidism?

Constipation.

Which type of adrenal disorder is illustrated?

Cushing syndrome.

Which condition is the goal for treating hypocalcemia?

Decreasing the pH.

Which clinical manifestation is seen with Addison's disease?

Delusions.

Which complication may arise if pheochromocytoma is left untreated?

Diabetes mellitus.

Which nursing intervention would be taken to provide relief to a patient who is complaining of a severe headache after a hypophysectomy?

Elevate the head of the bed to a 30-degree angle.

Which physiologic factor is related to the development of Cushing syndrome?

Excessive secretion of adrenocorticosteroid hormones.

Which parameter is monitored that would indicate a corticosteroid imbalance after surgery in a patient with Cushing syndrome?

Fluid intake.

Which condition shows a clinical presentation of purplish red striae?

Hyperfunction of glucocorticoids.

Which assessment finding is the highest priority for a patient with myxedema?

Hypothermia.

Which condition correlates with syndrome of inappropriate antidiuretic hormone secretion (SIADH) after a head injury?

Increased intravascular volume.

Which clinical manifestation would the nurse assess in a patient admitted with hyperparathyroidism?

Lethargy and weakness.

Which treatment is given to a patient with pheochromocytoma to control high BP before surgery?

Phenoxybenzamine.

A transsphenoidal hypophysectomy involves surgical resection of which gland?

Pituitary.

Which nursing intervention would promote a reduction in the release of antidiuretic hormone (ADH) in a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

Positioning the head of the bed flat.

Which disorder is characterized by excessive secretion of the hormone vasopressin?

Syndrome of inappropriate antidiuretic hormone secretion.

Which symptom is most important for the nurse to notify the health care provider about when caring for a patient with a history of hyperthyroidism who is admitted with a foot infection?

Temperature 103 F.

A patient who had surgery for the treatment of acromegaly asked about the possibility of becoming pregnant. The nurse's response would be based on which physiologic factor?

There will be a permanent loss of hormones.

Which rationale is accurate for checking Trousseau's sign in a patient following a subtotal thyroidectomy?

To assess for parathyroid gland injury.

The patient experiencing thyrotoxicosis asks the nurse why he or she is being given propranolol. Which answer is accurate when responding to the patient's question?

To block the sympathetic nervous system response to excess thyroid hormone.

Which rationale would the nurse give a patient who had a hypophysectomy to avoid vigorous coughing and sneezing?

To prevent cerebrospinal fluid leakage.

Which clinical manifestation would be most prominent in the assessment of a patient with suspected Cushing syndrome?

Weight gain, including truncal obesity.

A patient reports muscle weakness and swelling and has a low serum potassium level. Which hormone may be the cause of the assessment findings?

Aldosterone.

The patient with small cell lung cancer experiences a sudden 5-pound weight gain without edema and a decreased urinary output. Serum sodium is 128 mEq/L. Which treatment would the nurse plan to teach the patient about?

1000 mL per day fluid restriction.

What patient is at greatest risk for developing colon polyps and colorectal cancer and should have a screening colonoscopy every three to four years?

A patient with acromegaly.

A patient is instructed to ingest 75 g of glucose orally as a part of an oral glucose tolerance test. In addition, growth hormone measurements are taken consecutively at 30, 60, 90, and 120 minutes. Glucose levels and growth hormone levels are found to be constant during the test. Which disorder do these findings indicate?

Acromegaly.

Which intervention would be done immediately if a patient with adrenocortical insufficiency develops Addisonian crisis?

Administer large volumes of saline and dextrose.

Which hormone deficiency may lead to a life-threatening condition?

Adrenocorticotropic hormone (ACTH.)

Which effect may be observed if large amounts of endogenous corticosteroids are released into systemic circulation during surgery on a patient with Cushing syndrome?

Infections.

The nurse would implement which nursing action when caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

Initiate seizure precautions.

When developing a teaching plan for the patient with exophthalmos, which topic would be the highest priority?

Preventing corneal injury.

Which immediate postoperative risk would the nurse monitor in a patient who is returning from an adrenalectomy for an adrenal gland tumor?

Rapid BP changes.