Endocrine System
discard the urine and note the time
A client with disorder affecting the adrenal medulla must collect a 24-hour urine specimen. What nursing intrsuction is accurate when the client voids for the first time?
the transplant eliminates the need for insulin injections
A client with type 1 diabetes mellitus asks a nurse to identify the goal of a pancreas and islet cell transplant.What is the nurse's most accurate answer?
Risk factors for endocrine disorders
Age, Heredity, Congenital factors, Trauma, Environmental factors, Consequence of other disorders.
Decreased urinary output
Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
reassure the client that the substance poses no danger.
How can the nurse allay a client's fear about a test that involves a radioactive substance?
Administration of regular insulin
How can the nurse anticipate that the client with diabetic ketoacidosis will be treated?
hypophysectomy
Removal of a pituitary tumor via craniotomy or sublanial transsphenoidial(endoscopic or transnasal) approach (the latter approach is preferred b/c it is associated w/ fewer complications
Apply a moisturizuring lotion to dry feet, but not between the toes
The nurse is assisting with preparing a teaching plan for the client with diabetes mellitus regarding proper foot care.Which instruction should be included in the plan of care?
"I am urinating a lot."
The nurse is monitoring a client who has been newly diagnosed with diabetes mellitus for signs of complications.Which statement made by the client would indicate hyperglycemia and thus warrant primary health care provider(PHCP) notification?
Laryngeal stridor
There nurse is caring for a postoperative parathyroidectomy client.Which would require the nurse's immediate attention?
-Check the vital signs frequently. -Attend to complaints of neck fullness. -Feel the posterior neck area -Inspect the neck dressing
Which of the following nursing actions are essential for identifying hemorrhage following a thyroidectomy. SATA
check the urine with a test strip
Which of the following nursing actions helps the nurse to detect evidence of albuminuria when carrying for a client with diabetic neuropathy ?
moon face Buffalo Hump Abdominal striae Hirsutism in females
Which of the following nursing assessment data is the nurse likely to detect when caring for a client with Cushing's syndrome? SATA
Observe fro the presence of cerebrospinal fluid
Which of the following post op nursing actions should the nurse perform when a client with acromegaly has nasal packing ?
Potassium iodide suppresses thyroid-releasing hormone.
While awaiting surgery to remove an enlarged thyroid gland, the physician orders potassium iodide. What is the best nursing rationale for this drug order?
It can lead to adrenal sufficiency
Why is a client instructed to not stop their corticosteroid medication abruptly ?
They can cause disulfiram-type reactions
Why should sulfonylureas not be taken with alcohol ?
Maintain a patent airway
a client is admitted to the emergency department , and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially?
During mid-day
a nurse adminsters NPH insulin, which is classified as intermidiate acting. At what time should the nurse expect the client to most likely to experience hypoglycemia?
Lispro (Humalog)
a nurse should have a client's dietary tray immediately available when administering which of the following types of insulin?
Dexamethasone
a potent long acting corticosteroid given at bedtime, should suppress morning cortisol in clients with Cushing's disease
Endocrine glands
adrenal hypothalamus ovaries pancreas parthyroid pituitary testes thyroid
cough syrup
after the nurse obtains a drug history from a client, which drug category has the potential to affect the accuracy of a thyroid test?
diabetes insipidus
antidiuretic hormone is not secreted adequately, or the kidney is resistant to its effect
Needle aspiration of thyroid tissue
aspiration of the thyroid tissue is done for cytological examination, light pressure is applied to the aspiration site after the procedure
glycosylated hemoglobin (HbA1C)
blood test used to diagnose diabetes and monitor its treatment by measuring the amount of glucose bound to hemoglobin in the blood
Signs of tetany
cardiac dysrythmias, carpopedal spasm, dysphagia, muscle cramps, numbness of face and extremities, positive Chvostek's sign, positive Trousseau's sign, photophobia, wheezing and dyspnea.
myxedema
caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism
SIADH
condition of hyper functioning of the posterior pituitary gland in which excess ADH is released, but not in response to the body's need for it
Thyroid storm
fever, tachycardia, systolic hypertension,NVD, agitation, tremors, anxiety, restlessness, confusion, and seizures, delirium and coma
acromegaly
hypersecretion of growth hormone from the anterior pituitary after puberty, leading to enlargement of extremities
thyroid scan
identifies nodules or growths in the thyroid gland
radioactive iodine uptake
measures the absorption of an iodine isotope to determine how the thyroid gland is functioning
The "master" gland
pituitary gland
What should we monitor for and report after a transsphenoidal hypophysectomy
postnasal or clear nasal drainage, which might indicate a cerebrospinal fluid leak.Clear drainage should be checked for glucose
Addison's disease
requires lifelong replacement of glucocorticoids and possibly of mineralocorticoids, if significant hypo secretion occurs; the condition is fatal if left untreated
T3 and T4 resin uptake test
T3 and T4 regulate thyroid stimulating hormone. T3 is elevated in hyperthyroidism and may be decreased in hypothyroidism. T4 is elevated in hyperthyroidism and decreased in hypothyroidism.
Prednisone (Deltasone)
What medication can contribute to hyperglycemia
The clients urine output is a normal amount
What nursing assessment indicates that a client with DI is experiencing a therapeutic response to Tx?
Symptoms of hyperthyroidism such as tachycardia, chest pain, palpations, and excessive sweating (signs of toxicity)
What symptoms should a client that is taking a thyroid hormone report ?
rapid and short acting insulin
What two insulins can only be administered intravenously?
Glargine, Detemir
What two insulins can't be mixed with any other type of insulin
Shellfish
When assessing a client with a suspected thyroid disorder prior to a nuclear scan, what type of allergy is most important for the nurse to report?
radiological study with the administration of intravenous contrast dye
When should metformin be withheld temporarily before this study
Administer oral glucose tablets
When the nurse administers an alpha-glucosidase inhibitor like miglitol (glyset), how should the nurse manage hypoglycemia if it occurs?
Tremors of the hands Heat intolerance Insomnia
When the nurse asses a client with a thyroid disorder, which of the following findings are associated with hyperthyroidism? SATA
" I will notify my primary health care provider is my blood glucose level is consistently greater than 250."
When the nurse is reinforcing instructions to a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective?
the client's facial muscles spasm
When the nurse taps over a clients facial nerve, what response is indicative of hypocalcemia due to accidental removal of the parathyroid glands during a thyroidectomy?
Verbally explain the test. Provide a printed pamphlet. Include a family member.
Which nursing strategies are appropriate when carrying for an older client who is scheduled for a diagnostic test ? SATA
Stock quick-acting carbohydrates
Which of the following actions is most appropriate when a nurse cares for a client with diabetes mellitus is on the hospital unit?
Epinephrine (adrenaline)
Which of the following drugs will the physician most likely order the nurse to administer in the case of an allergic reaction to contrast medium ?
provide a general explanation to the client.
Which of the following is an appropriate nursing intervention when preparing a client for a CT scan?
Remain in air-conditioned areas
Which of the following is best for the nurse to suggest to a client with diabetes insipidus to reduce fluid loss during hot and humid weather?
posterior pituitary disorders
-diabetes insipidus -SIADH
Thyroidectomy preoperative interventions
-obtain vitals signs and weight -monitor electrolyte levels -monitor for hyperglycemia
suppression test
-used when hormone levels are high or in the upper range of normal. -drugs or substances known to normally suppress hormone production are administered. -failure of suppression or hormone production during testing indicates hyperfunction.
Diagnostic test for pheochromocytoma
24-hour urine collection for vanillylmandelic acid (VMA)
Normal HGBA1C reference intervals:
4.0% to 6.0%
The normal t4 levels are
5mcg/dl to 12.0mcg/dl
The normal T3 ( total serum) levels are
70ng/dl to 205ng/dl
Skeletal
A client diagnosed with parathormone deficiency is admitted to the hospital. As the nurse initiated the care plan what body system should be the focus?
Drowsiness,fruity breath, flushed skin, deep breathing
A client is brought to the emergency department with suspected diabetic ketoacidosis. What assessment findings will the nurse identify with this condition?
6 to 14 hours after administration
A client is taking Humulin NPH insulin daily every morning.The nurse reinforces instructions to the client and should tell the client that which is the most likely time for a hypoglycemic reaction to occur?
Follicle-stimulating hormone (FSH)
A client who has amenorrhea asks the nurse what hormone deficiency would be tested. The nurse is correct in identifying which one of the following?
rotate the insulin injection sites systemically.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections.Which teaching information should the nurse reinforce upon discharge?
Blood
A client who is scheduled for a thyroid panel consisting of measurements of TSH,T3, and queried. What is the most accurate answer?
" I should not exercise in the late afternoon"
A client with type one 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?
seafood
Before the nurse schedules a client for a diagnostic test involving contrast medium, an allergy to which substances should be identified?
When should a client with diabetes mellitus measure their blood sugar when exercising
Before, during and after exercising
Hypothalamus hormones
CRH,GnRH,GHIH,GHRH,MIH,PIH,TRH
hoarse vocalization
Following a thyroidectomy, which of the following should the nurse suspect as being the result of laryngeal nerve damage?
Anterior pituitary disorders
Hypopituitarism Hyperpituitarism
Addisonian crisis
N/V confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP
What is a cause of an increase of HbA1c value ?
Poor glycemic control in a client with diabetes mellitus
" I can take aspirin or my antihistamine if I need it "
The home health care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made b y the client indicates a need for further teaching?
refrigerate the insulin
The homeware nurse visits a client recently diagnosed with diabetes mellitus who is taking humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should provide which information?
Dry skin, Constipation,Cold intolerance
The nurse educator is asking the nursing student to recall the signs and symptoms of hypothyroidism. The nurse educator determines that the student understands this disorder is which are included in the students response? SATA
monitor blood glucose level frequently
The nurse is reinforcing instructions to 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?
plan for injection rotation
The nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs.Which further information should the nurse obtain from the client during data collection?
"I need to buy special diabetic foods"
The nurse provides dietary instructions to a client with diabetic mellitus regarding the prescribed diabetic diet.Which statement made by the client indicates the need for further teaching?
Shakiness
The nurse reinforces teaching to a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. the client demonstrates an understanding of the teaching by stating that glucsose will be taken if which symptom develops?
place the client in a semi fowlers position and notify the RN immediately. The nurse should prepare to administer oxygen.
The nurse suspects that a client with pheochromocytoma is developing hypersensitive crisis. what should the nurse do?
Withdraws the NPH insulin first
The nursing is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates need for further teaching?
the nurse is caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed. The nurse determines that this medication has been prescribed for which reason?
Treat hypocalcemia tetany
What do we reassure clients before a thyroid scan
We reassure clients that the level of radioactive medication isn't dangerous to self or to others
Have another nurse check the amount and type of insulin against the order
What is the best method the nurse can use to avoid a medication error when administering insulin?
Pulse ox Trach tray Ice bag Calcium gluconate
What items should the nurse have available when a client recovers from a thyroidectomy? SATA
1.Diarrhea can occur secondary to metformin 2.The repaglinde is not taken if a meal is skipped 3.The repalinide is taken 30 minutes before eating 4.Candy or another simple sugar is used to treat mild hypoglycemia episodes
the home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. the client, prescribed repaglinde and metformin, asks the nurse to explain these medications. The n nurse should reinforce which instructions to the client? SATA
"Forceful palpation can result in excessive release of thyroid hormone from the gland "
the nurse gently palpates the ne k of the client diagnosed with a thyroid disorder. the client asks why the nurse's touch is so gentle. what response by the nurse is most appropriate.
Reassure the client that this is usually a temporary condition
the nurse is collecting data regarding a client after a thyroidectomy and notes the development of a hoarse and weak voice.Which nursing action is appropriate ?
-Insomnia -Weight loss -Mild heat intolerance
the nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism.Which findings indicate the presence of a side effect associated with this medication?SATA
"I can eat foods that contain potassium."
the nurse is reinforcing discharge teaching to a client who has Cushing's syndrome.Which statement by the client indicates that the instructions related to dietary management were understood?
Stimulation test
used in patients with a suspected underachieve endocrine gland, a stimulus is used to determine whether the gland is capable of normal hormone production
Overnight dexamethasone suppression test
used to distinguish between bushings syndrome and cushings disease
