Chp 51 Endocrine Disorder Part 1 & 2

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia. Which statement by the client indicates a correct understanding of Humulin N insulin and exercise?

"I should not exercise in the late afternoon."

The nurse is caring for a client with Addison's disease. The nurse checks the client's vital signs and determines that the client has orthostatic hypotension. The nurse determines that this finding relates to which factor?

A decreased secretion of aldosterone

A client with diabetes mellitus calls the clinic and tells the nurse that she has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the appropriate nursing response?

Administer the full dose as prescribed

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?

Antidiuretic hormone (ADH)

Desmopressin acetate(DDVAP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to :

Destroy some of the thyroid tissue.

The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug?

Drop in blood pressure

A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?

Early morning

The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine?

Eggs

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which symptom is indicative of this disorder?

Excessive thirst and urine output

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?

Fasting blood sugar (FBS)

The nurse is caring for a client following an adrenalectomy and is monitoring for signs of adrenal insufficiency. Which are signs and symptoms related to adrenal insufficiency? Select all that apply.

Fever Hypotension Weakness Mental Status Changes

The nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which is the appropriate choice for this client to meet nutritional needs?

Graham crackers and warm milk

A client received a dose of regular insulin (Humulin R) this morning at 7:00 am. At which time should the nurse likely anticipate the potential for a hypoglycemic reaction to occur?

10 am

The human insulin whose onset of action occurs within ____ minutes is lispro (Humalog).

15 mins

A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potential lethal complication of :

Congestive heart failure

A hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

Adrenal suppression

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

How should the nurse administer insulin to prevent lipohypertrophy?

At room temperature

What instructions should a nurse give to a diabetic patient to prevent injury to the feet?

Avoid going barefoot and always wear shoes with soles.

A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include?

Calorie-restricted meals

The nurse enters the room of a client with type 1 diabetes mellitus and finds the client difficult to arouse. The client's skin is warm and flushed, and the pulse and respiratory rate are elevated from the client's baseline. Which action should the nurse implement?

Check the client's capillary blood glucose

As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as?

Chvostek sign

What is the term for a chemical messenger that travels throughout the bloodstream to its target organ?

Hormone

A client with type 2 diabetes mellitus has a blood glucose of more than 600 mg/dL and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the health care provider's documentation and would expect to note which diagnosis?

Hyperglycemic hyperosmolar state (HHS)

A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication?

Laryngeal spasms

What do the Chvostek sign and Trousseau sign indicate?

Low levels of serum calcium

What should the nurse include in provisions for the postoperative care of the patient who had thyroidectomy? (Select all that apply.)

Maintaining anatomic position of the head when moving a patient Doing voice check every 2 hours Checking for bleeding at the sides and the back of the head

The nurse is reinforcing instructions with a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) regarding measures to prevent a recurrence. Which instruction is important for the nurse to emphasize?

Monitor blood glucose levels frequently

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information?

Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.

The nurse notes in the medical record that a client with Cushing's syndrome is experiencing fluid overload. Which interventions should be included in the plan of care? Select all that apply.

Monitoring intake and output Monitoring extremities for edema Monitoring Daily Weight Maintaining a low-sodium diet

Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that which is the best time to take the insulin?

Once daily, at the same time each day

What is the master gland of the endocrine system?

Pituitary

A patient has come to the clinic because of the enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with the :

Pituitary gland

The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for:

Protecting patient from injury

What instructions should be included in the discharge instructions for a 47-year-old patient with hypothyroidism?

Seeing the physician regularly for follow-up care

What is the postoperative position for a person who has had a thyroidectomy?

Semi- Fowler

The nurse reinforces teaching with a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which symptom develops?

Shakiness

The nurse is caring for a postoperative adrenalectomy client. Which finding does the nurse specifically monitor for in this client?

Signs and symptoms of hypovolemia

What information should be obtained from the patient before an iodine-131 test?

Status of possible pregnancy

A client is newly diagnosed with hypothyroidism. Levothyroxine (Synthroid) is prescribed. The nurse should reinforce to the client which instructions about the medication ?

Take on an empty stomach

The nurse explains that the negative feedback system controls hormone release by communication between :

The pituitary and the target organ

A patient with history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patient's vital signs: T 103 degree F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. what does the patient most likely have?

Thyroid storm

Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa-zole)?

To block the production of the thyroid hormones

What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient?

Tracheotomy tray

Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.)

Tremors Diaphoresis Irritability

The nurse is preparing to administer an injection of regular insulin. The vial of the regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which action should the nurse take?

Wait for the insulin to thaw at room temperature

The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of:

hypoglycemic reaction; give 6 oz of orange juice