Diabetes MS Ch

A nurse is providing discharge teaching to a client who has diabetes insipidous and a new prescription of rdesmopressin nasal spray. Which of the following should the nurse include in the teaching.

"Depress the pump once before using the nasal spray for the first time."The nurse should instruct the client to prime the nasal spray pump by pressing down four times before the initial use. "Blow your nose gently prior to using the nasal spray."MY ANSWERThe nurse should instruct the client to blow his nose gently prior to using the spray. This action prevents dilution of the medication with nasal secretions. "Administer the nasal spray while in a side-lying position."The nurse should instruct the client to sit upright with their head tilted forward slightly when administering the spray. This upright position prevents the spray from going down the client's throat. "Notify the provider if you develop numbness or tingling around the mouth."Numbness or tingling around the mouth is a manifestation of hypocalcemia. Desmopressin can result in the adverse effect of hyponatremia.

A nurse is admitting a client who has hyperthyroidism. When assessing a client, the nurse should expect which of the following findings?

canswer c. Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia. a. Cold intolerance A client who has hyperthyroidism can experience heat intolerance. b. Lethargy A client who has hyperthyroidism can be restless and irritable. d. Sunken eyes A client who has hyperthyroidism can have exophthalmos, which causes a wide-eyed or startled appearance.

edema

is primarily due to sodium and water retention

hyponatremia

is primarily due to the intake of water that cannot be excreted

hypernatremia

is primarily due to the loss of water that has not been replaced

hypovolemia

represents the loss of sodium and water

A nurse is managing the care of a patient who is postoperative and has acute adrenal insufficiency. What medication should the nurse give the patient?

IV Hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency

A nurse is planning teaching for a client who has type one diabetes mellitus. Which of the following instructions should the nurse plan to include?

a. Consume no more than three servings of alcohol per day. b. Ingest food with alcohol to reduce alcohol-induced hypoglycemia. c. Increase insulin dosage before planned exercise. d. Rest for 3 days between periods of vigorous exercise. answer: b. Ingest food with alcohol to reduce alcohol-induced hypoglycemia. **Alcohol inhibits the liver's production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia. a. Consume no more than three servings of alcohol per day. The nurse should recommend that male clients drink no more than two servings of alcohol per day, and female clients drink no more than one serving of alcohol per day. c. Increase insulin dosage before planned exercise. The nurse should instruct the client to reduce insulin dosage before planned exercise to prevent hypoglycemia. d. Rest for 3 days between periods of vigorous exercise. The nurse should instruct the client to exercise at least three times per week and have no more than 2 consecutive days without exercise.

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy.

a. Fasting blood glucose 96 mg/dL b. Postprandial blood glucose 195 mg/dL c. Random blood glucose 210 mg/dL d. Preprandial blood glucose 60 mg/dL answer: a. fasting blood glucose 96 mg/dL This is within the expected reference range of 70 to 110 mg/dL for a fasting blood glucose level and indicates that insulin therapy is effective. b. Postprandial blood glucose 195 mg/dL postprandial blood glucose level of 195 mg/dL is above the expected reference range of less than 180 mg/dL. c. Random blood glucose 210 mg/dL A random blood glucose level of 210 mg/dL is above the expected reference range of less than 200 mg/dL. d. Preprandial blood glucose 60 mg/dL A preprandial blood glucose level of 60 mg/dL is below the expected reference range 70 to 130 mg/dL.

A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective.

a. Increase ability to sweat b. Increased bowel movements c. Increased body weight d. Increased libido a. Diaphoresis is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease diaphoresis. b. Increased bowel movements is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease bowel movements. c. Increased body weight. Propylthiouracil suppresses the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high. d. Increased libidoIncreased. libido is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease libido.

A nurse is monitoring a client who is 24 post operative after a total thyroidectomy. Which of the following findings should the nurse report to the provider.

a. Laryngeal stridor b. Productive cough c. Pain with hyperextension of the neck d. Hoarse, weak voice answer: a. Laryngeal stridor Laryngeal stridor is a harsh, high-pitched sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway. b. Productive coughA productive cough can occur after general anesthesia due to a buildup of secretions caused by endotracheal intubation. c. Pain with hyperextension of the neckPain with hyperextension of the neck is an expected finding after a thyroidectomy. The nurse should use pillows to support the client's head and neck. d. Hoarse, weak voiceA hoarse and weak voice is common after general anesthesia as a result of endotracheal intubation. If hoarseness continues, it could indicate laryngeal nerve damage, which is usually transient.

A nurse is assessing a client who has adrenal insufficiency. Which of the following finding should the nurse expect?

a. Moon-shaped face b. Weight gain c. Calcium 12.8 mg/dL d. Sodium 150 mEq/L answer: c. Calcium 12.8 mg/dL **A client who has adrenal insufficiency will have a calcium level above the expected reference range of 4.5 to 5.6 mg/dL. a. Moon-shaped face A rounded face, or a moon-shaped face, is a finding of Cushing's disease. b. Weight gain Weight loss is a finding of adrenal insufficiency. d. Sodium 150 mEq/L A client who has adrenal insufficiency will have a sodium level below the expected reference range of 136 to 145 mEq/L..