PrepU Chapter 41

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which metabolic abnormality can lead to the development of type 2 diabetes

insulin resistance

what maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia?

maternal diabetes

which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes?

monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed

select the most common symptoms of diabetes. Select all that apply

polydipsia, polyuria, polyphagia

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

"with treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize"

which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

Is morbidly obese (greater than 100 pounds over ideal weight)

the signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process?

Addison disease

A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant taking thyroid hormone supplement, what should be included in the education?

The infant will have dosage levels adjusted as he grows

a nurse is evaluating clients risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

a middle aged obese adult with a sedentary lifestyle

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis?

beta cell exhaustion due to long-standing insulin resistance

when caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source?

brain

which test can the nurse prepare the client to determine the differentiation between a benign and malignant thyroid disease?

fine-needle aspiration biopsy

the nurse is caring for a child with congenital adrenal hyperplasia and has depletion of sodium levels. What pharmacologic therapy does the nurse anticipate administering to this child?

fludrocortisone acetate

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

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

hyperglycemia

which manifestation in client with Addison disease results from negative feedback

hyperpigmentation

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 lab results from the client, what does the nurse anticipate seeing?

increased levels of ACTH

A newborn is found to have transient hypothyroidism following a cesarean birth. Which nursing intervention could have induced the transient hypothyroidism as the staff prepared the mother for the surgical procedure?

performing a skin scrub with povidone-iodine solution on delivery site

A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:

teach the client about the safe and effective use of synthetic thyroid hormones.

The nurse is providing discharge instructions for a client with graves disease who has ophthalmopathy. what should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?

the client should be strongly urged to not smoke

the nurse is providing education for a client diagnosed with hyperthyroidism. What information about diet should the nurse be sure to include in this information?

the client should maintain a low cholesterol diet


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