Chapter 49.3

A patient with endogenous Cushing syndrome shows a persistent rise in blood glucose levels. What drug would be administered to control glucose levels?

Mifepristone

What level of urine cortisol indicates Cushing syndrome?

130 mcg/24 hr

The nurse, providing care to a patient with Cushing's syndrome, understands that the disorder is primarily related to:

Excessive secretion of adrenocorticosteroid hormones

Which parameter is assessed for corticosteroid imbalance after surgery in a patient with Cushing syndrome?

Fluid intake

A patient has developed Cushing syndrome due to the prolonged administration of corticosteroid hormonal therapy. What course of action should be taken to treat the patient?

Gradual discontinuance of corticosteroids

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 patient is brought to the emergency department following a car accident and is wearing medical identification that says the patient has Addison's disease. What should the nurse expect to be included in the collaborative care of this patient?

Increased glucocorticoid replacement

Which finding is consistent with a diagnosis of hyperaldosteronism?

Hypernatremia

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

Adrenocorticotropic hormone (ACTH)

Which is a clinical manifestation of Cushing syndrome?

Hypokalemia

A patient is scheduled for a bilateral adrenalectomy. What does the nurse include in the discharge teaching for this patient?

Lifelong replacement of corticosteroids will be required.

The nurse is teaching a patient with Cushing syndrome about home care. Which statement made by the patient indicates effective learning?

"I will wear a Medic Alert bracelet all the time."

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

glucose

A patient with hyperaldosteronism is prescribed eplerenone. What advice would the nurse give the patient regarding eplerenone?

"Avoid grapefruit juice."

The nurse is teaching a patient with Addison's disease about corticosteroid therapy. The nurse should prioritize which of these teaching points?

"Do not stop taking the medication abruptly."

A patient with pheochromocytoma is prescribed propranolol during preoperative care. Which instruction provided by the nurse is most appropriate to prevent complications in the patient?

"Make postural changes cautiously."

A patient with adrenal insufficiency is advised to take corticosteroids for four months. What should be told to the patient about how to prevent osteoporosis? Select all that apply.

"Take vitamin D tablets." "Avoid high-impact exercise."

The patient has a prescription to receive 45 mg of prednisone by mouth daily. Available are 10 mg tablets. How many tablets should the nurse prepare to give? Fill in the blank using one decimal place. ________ tablet(s)

4.5 tablets

A nurse creating a plan of care for a patient with Addison's disease expects that primary treatment will include:

Adrenocorticosteroid replacement therapy

A patient with adrenocortical insufficiency develops Addisonian crisis. What should be the immediate nursing action?

Administer large volumes of saline and dextrose.

What may be the cause of iatrogenic Addison's disease?

Adrenal hemorrhage

Which disease is treated with corticosteroidal hormonal therapy?

Adrenal insufficiency

What treatment would be provided to a patient with bilateral adrenal hyperplasia to block aldosterone synthesis?

Aminoglutethimide

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

Autoimmune polyglandular syndrome

What is the clinical manifestation of Addison's disease?

Delusions

What complications may arise if pheochromocytoma is left untreated?

Diabetes mellitus

Which hormone has both mineralocorticoid and glucocorticoid properties?

Hydrocortisone

Which condition may be linked to Conn's syndrome?

Hyperaldosteronism

Which condition shows a clinical presentation of purplish red striae?

Hyperfunction of glucocorticoids

A nurse is caring for a patient who has Addison's disease. The nurse should assess the patient for which symptoms? Select all that apply.

Hyperpigmentation Weakness and fatigue Orthostatic hypotension

The nurse creates a plan of care for a patient with a pheochromocytoma. What is an appropriate expected outcome for the patient?

Maintaining a normotensive state

In developing a teaching plan for the patient with Addison's disease, what is the nurse's highest priority?

Managing lifelong corticosteroid replacement

What treatment is given to a patient with pheochromocytoma to control high blood pressure during preoperative care?

Phenoxybenzamine

A patient has been taking oral prednisone for the past several weeks after having an exacerbation of asthma. The nurse has explained the procedure for gradual reduction rather than sudden cessation of the drug. What is the rationale for this approach to drug administration?

Prevention of adrenal insufficiency

The patient with an adrenal hyperplasia is returning from surgery for an adrenalectomy. For what immediate postoperative risk should the nurse plan to monitor the patient?

Rapid blood pressure changes

The nurse is teaching the patient with adrenocortical insufficiency and the caregiver about management of corticosteroid therapy. What should the nurse tell the patient and the caregiver?

Recognize edema and ways to restrict sodium intake.

Which statement is true about pheochromocytoma?

Severe pounding headaches and profuse sweating are clinical features.

A patient is diagnosed with Cushing syndrome and the cause was found to be a pituitary adenoma. What treatment should be provided to the patient?

Transphenoidal resection

Which test is more reliable to diagnose pheochromocytoma?

Urinary creatinine