PrepU Ch 13
The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan?
Hydrocortisone
The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?
To decrease airway inflammation
The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?
"Because cortisol levels fluctuate, collecting a sample over time will be more accurate."
What is the most common mechanism of hormone control?
Negative feedback
When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:
06:00 to 08:00 AM
The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.
ACTH peaks in the morning and declines throughout the day.
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process?
Addison disease
The nurse is caring for a client with impairment of the adrenal gland. The nurse notes abnormal sodium and potassium levels. Which hormone is the most likely to be impaired?
Aldosterone
The nurse is caring for a client being treated for diabetes insipidus after cranial surgery. The client has intravenous (IV) fluids infusing and has an indwelling urinary catheter. The nurse notes no urine output in the past hour. Which action is the nurse's priority?
Assess the urinary catheter and drainage system.
The nurse is planning care for a client with Cushing syndrome secondary to a pituitary tumor. Which interventions will the nurse include in the plan of care? Select all that apply.
Avoid invasive procedures, Assess blood glucose levels, Reposition frequently, Encourage foods high in calcium.
Which complication of acromegaly can be life threatening?
Cardiac structures increase in size
The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?
Cretinism
The nurse is reviewing the test results of a client who was given thyrotropin-releasing hormone (TRH) to evaluate the function of the pituitary gland. The nurse would recognize pituitary dysfunction as:
Decreased TSH levels
Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?
Excess ACTH production by a pituitary tumor
The nurse is caring for a client with adrenal hyperplasia. What is the nurse's understanding of the etiology of the condition?
Excessive hormonal stimulation
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?
Eye health and visual acuity
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
Graves disease
The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?
Heart rate 110 and bounding
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
Hormone stimulation
Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
Hypothyroidism
When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?
Increase in appetite
What is a predominant effect of a prolonged excessive growth hormone level?
Increased blood glucose levels
The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?
Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?
Increased levels of ACTH
A client diagnosed with metabolic syndrome and growth hormone (GH) deficiency will likely display which physical assessment finding?
Increased visceral fat
The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?
Negative feedback loop
The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which sign/symptom?
Ophthalmopathy
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
Which physiologic process is a direct effect of the release of growth hormone by the anterior pituitary?
Production of insulin-like growth factors (IGFs) by the liver
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?
Proteins
The nurse is caring for a client with Cushing syndrome. Which renal manifestation does the nurse expect to find?
Renal calculi
A client undergoing a cardiac angiogram has also had serum thyroid panel study. The physiologic principle behind looking at thyroid panels includes which possible correlations with cardiac symptoms? Select all that apply.
Rise in oxygen consumption & Increase in cardiac output
A client has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which treatment modality is most likely to benefit this client?
Synthetic preparations of T3 or T4
Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply.
Tachy, Delirium, Very high fever
Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply.
Temperature of 104.2°F (40.1°C), Telemetry showing heart rate of 184, Extremely agitated
When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?
The hypothalamic-pituitary-target cell system
A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?
Thyroid storm
Paracrine action involves which characteristic?
act locally on cells other than those that produce the hormone
The nurse is caring for a client with a hormonal disorder that is widely affecting many body systems. The nurse recognizes that which form of hormone signalling pathway is most likely involved in the client's disorder?
endocrine
Which physiologic process best exemplifies a positive feedback mechanism?
increase in prolactin secretion that occurs with more frequent breastfeeding
The nurse is teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?
protein carriers
When comparing the endocrine and nervous system functions, the nurse knows that the endocrine system:
releases hormones into the blood that is transported throughout the body, glands are widely scattered throughout the body, takes longer to respond to innervations but has prolonged actions when they arrive