Endocrine

Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?

new-onset changes in the patient's voice

Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

offer the patient hard candies to suck on

After a patient with a pituitary adenoma has had a hypophysectomy, the nurse will teach about the need for

oral corticosteroids to replace endogenous cortisol

Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos?

elevate the head of the patient's bed to reduce periorbital fluid

A 61-yr-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels.

Parathyroid hormone

The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include

decreased facial hair

A 56-yr-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)

decreased serum sodium

An 82-yr-old patient in a long-term care facility is newly diagnosed with hypothyroidism. The nurse will need to consult with the health care provider before administering the prescribed

diazepam (Valium)

During the nurse's physical examination of a young adult, the patient's thyroid gland cannot be felt. The most appropriate action by the nurse is to

document that the thyroid was nonpalpable

A patient will be scheduled in the outpatient clinic for blood cortisol testing. Which instruction will the nurse provide?

"Come to the laboratory to have the blood drawn early in the morning."

A 40-yr-old patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask?

"Do you have to wear larger shoes now?"

Which question from a nurse during a patient interview will provide focused information about a possible thyroid disorder?

"Have you had a recent unplanned weight gain or loss?"

The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?

"I need to shop for foods low in sodium and avoid adding salt to food."

Which statements will the nurse include when teaching a patient who is scheduled for oral glucose tolerance testing in the outpatient clinic

- "You will need to avoid smoking before the test." - "Several blood samples will be obtained during the testing." - "The test requires that you fast for at least 8 hours before testing."

A patient is to receive methylprednisolone (Solu-Medrol) 100 mg. The label on the medication states: methylprednisolone 125 mg in 2 mL. How many milliliters will the nurse administer?

1.6

An 18-yr-old male patient with small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain

50% dextrose solution

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

A 70-year-old female patient taking levothyroxine (Synthroid) who has an irregular pulse of 134

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is important for the nurse to communicate to the health care provider before the test?

Allergies to iodine and shellfish

The nurse reviews a patient's glycosylated hemoglobin (A1C) results to evaluate

Glucose control over the past 90 days

The nurse is caring for a 45-yr-old male patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider?

The patient has a 5-lb (2.3-kg) weight loss

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

Thyroid-stimulating hormone (TSH) level

A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L). Which nursing action should be included in the plan of care?

encourage 4000 mL of fluids daily

The nurse will plan to teach a patient to minimize physical and emotional stress while the patient is undergoing

a 24-hour urine test for free cortisol

A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid relief from the symptoms?

have the patient rebreathe from a paper bag

The nurse will plan to monitor a patient diagnosed with a pheochromocytoma for

headache

The nurse is caring for a 63-yr-old with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. Which information about the patient is important to discuss with the health care provider before the test?

history of renal insufficiency

Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?

increased thyroxine (T4) level

A young adult patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory test results to show

increased urinary cortisol

A 37-yr-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon?

increasing neck swelling

Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency?

increasing serum sodium levels

After obtaining the information shown in the accompanying figure regarding a patient with Addison's disease, which prescribed action will the nurse take first?

infuse 5% dextrose and 0.9% saline

Which information will the nurse include when teaching a 50-yr-old male patient about somatropin (Genotropin)?

inject the medication subcutaneously every day

A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?

ionized calcium

The nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

keep the specimen refrigerated or on ice

The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included?

measure urine volume every hour

The nurse providing care for a patient who has an adrenocortical adenoma causing hyperaldosteronism should

monitor the blood pressure every 4 hours

Which finding by the nurse when assessing a patient with a large pituitary adenoma is most important to report to the health care provider?

nausea and projectile vomiting

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

patient stopped taking the medication 2 days ago

The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring. Which patient should be transferred to the cardiac unit first?

patient with tetany who has a new order for IV calcium chloride

Which prescribed medication should the nurse expect will have rapid effects on a patient admitted to the emergency department in thyroid storm?

propranolol (inderal)

A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to occur in 2 days. Which teaching strategy is likely to result in effective patient self-management at home?

provide written reminders of information taught

A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?

purplish streaks on the abdomen

A 44-yr-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for the patient problem of disturbed body image related to changes in appearance?

remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery

An expected patient problem for a patient admitted to the hospital with symptoms of diabetes insipidus is

sleep pattern disturbance related to frequent waking to void

Which statement by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

"I feel a lump in my throat when I swallow."

The nurse admits a patient to the hospital in Addisonian crisis. Which patient statement supports the need to plan additional teaching?

"I had the flu earlier this week, so I couldn't take the hydrocortisone."

A 29-yr-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include?

"The prednisone dose should be decreased gradually."

Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter?

"What medications are you taking?"

A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test?

Antidiuretic hormone level

A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. The nurse should plan to teach the patient about

calcium supplements to normalize serum calcium levels

A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse anticipate next?

administer IV calcium gluconate

A patient is admitted with diabetes insipidus. Which action will be appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?

administer prescribed subcutaneous DDAVP

Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease?

antithyroid medications may take several months for full effect

Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)?

apical pulse rate

A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?

assess the patient's respiratory effort

A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to

avoid brushing teeth for at least 10 days after the surgery

The nurse is caring for a patient following an adrenalectomy. The highest priority in the immediate postoperative period is to

balance fluids and electrolytes

Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse?

temperature 103.8 F (40.4 C)

A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient

that symptoms of hypothyroidism may occur as the RAI therapy takes effect

A registered nurse (RN) is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching?

the RN palpates the neck to assess thyroid size

Which assessment finding of a 42-yr-old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse?

the blood pressure (BP) is 88/50 mm Hg

Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)?

the patient has a serum sodium level of 118 mEq/L

The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider?

the patient is confused and lethargic

A patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. The nurse will monitor for

elevated serum potassium

Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?

the patient takes oral corticosteroids for rheumatoid arthritis

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?

the serum albumin

The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient's

urinary output is increased

A patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

value system