MED/SURG2: Chapter 49

A patient who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) has the serum sodium levels below 120 mEq/L and presents with neurologic manifestations such as seizures. What would be the most appropriate nursing intervention?

Administration of intravenous hypertonic saline solution

The nurse is caring for a patient with an alteration in the regulation of water balance and osmolarity. Which hormone will require alteration with medication?

Arginine vasopressin

A patient who underwent thyroid surgery develops neck swelling. What is the first action that the nurse should take?

Assess the patient for signs of hemorrhage

Which nursing intervention is a priority for a patient recovering from removal of a pituitary gland tumor?

Assessing for signs of increased intracranial pressure (ICP)

The nurse is caring for a patient with central diabetes insipidus (DI). What does the nurse recognize is a priority focus of care?

Avoiding dehydration and fluid volume deficit

A nurse caring for a patient with hyperparathyroidism should monitor the patient for which complication?

Cardiac dysrhythmias

The nurse provides a patient with a list of foods that fall under the category of goitrogens. What food item should be included on the list?

Cauliflower

The nurse is assessing a female patient that has developed fat pads on the back of the neck, an increased abdominal girth, facial hair growth, and a "moon" face. What disorder does this assessment data indicate?

Cushing syndrome

The endocrine system involves a number of organs and glands that secrete hormones. The posterior pituitary gland is responsible for secreting antidiuretic hormone (ADH). When the posterior pituitary gland overproduces ADH, a condition called the syndrome of inappropriate antidiuretic hormone (SIADH) develops. Which characteristics best describe SIADH?

Fluid retention, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume

A patient has recently undergone transsphenoidal hypophysectomy and reports a severe supraorbital headache. The nurse maintains the patient's head in an elevated position and requests the patient stay on bed rest for four days. Which finding in the laboratory report is the reason for this nursing action?

Glucose level 40 mg/dL in the nasal drainage

The nurse is reviewing a patient's laboratory reports that show increased levels of plasma insulin-like growth factor 1. What does this finding indicate about growth hormone levels?

Growth hormone levels are elevated

The nurse is educating family members regarding postsurgical complications for a patient who is undergoing hypophysectomy. Which complication should the nurse include in the teaching?

Infertility

A patient is scheduled for a total thyroidectomy. What information does the nurse include when teaching this patient about recovery after the procedure?

Life-long hormone replacement will be needed

The health care provider was unable to spare a patient's parathyroid gland during a thyroidectomy. Which assessments should the nurse prioritize when providing postoperative care for this patient?

Monitoring the patient's serum calcium levels and assessing for signs of hypocalcemia

Based on the laboratory data for a patient who presents with an enlarged thyroid gland, the nurse expects that which type of goiter will be documented in the patient's medical record?

Nontoxic

The nurse is reviewing the results of four diagnostic tests for diabetes insipidus (DI). Which patient's results indicate nephrogenic DI?

Patient B

What is a nursing priority in the care of a patient with a diagnosis of hypothyroidism?

Patient teaching related to levothyroxine

A patient is undergoing transsphenoidal hypophysectomy. The nurse is aware that the procedure involves surgical resection of what gland?

Pituitary

A young adult female patient with normal body weight has excessive hair growth on her face. Other symptoms include bitemporal hemianopsia, infrequent menstruation, and infertility. What type of endocrine disorder is suspected in the patient?

Prolactinomas

The nurse creates a plan of care for a patient with Graves' disease. What is an appropriate expected outcome?

The patient will demonstrate maintenance of his weight

The nurse assesses a patient with diabetes insipidus. The most important assessment finding is an increase in:

Urine output

The registered nurse is teaching a nursing student about the drug profile of octreotide. Which statement made by the student indicates the need for further teaching?

"Growth hormone levels are measured every four weeks."

The nurse is instructing a patient regarding self-management of syndrome of inappropriate antidiuretic hormone (SIADH). The patient has gastric ulceration as a comorbid condition. Which statement by the patient needs correction?

"I should drink the electrolyte solution after meals."

The nurse is performing discharge education for a patient who was admitted for acute hypothyroidism. The patient is undergoing thyroid hormone therapy for the first time. What statement by the patient to the nurse confirms that discharge teaching was effective?

"I should take my levothyroxine every morning before eating my breakfast."

A patient has just begun long-term corticosteroid therapy. The nurse determines that the patient requires further education when making which statement?

"If I begin to gain weight I should stop taking my medication."

A patient diagnosed with hyperthyroidism received radioactive iodine one week ago. The patient tells the nurse, "I don't think the medication is working, I don't feel any different." What is the best response by the nurse?

"It may take several weeks to see the full benefits of the treatment."

Which nursing interventions are appropriate when providing care to a patient that is recovering from a thyroidectomy? Select all that apply.

-Assessing for tetany -Monitoring vital signs -Assessing the patient every two hours on the first postoperative day

A patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum sodium level of 130mEq/L and complains of a severe backache. What are the most appropriate nursing interventions? Select all that apply.

-Assessing the patient's weight -Positioning the head of the bed flat -Restricting fluid intake to 900 mL/day

An older adult patient who has a history of coronary artery disease (CAD) is diagnosed with hypothyroidism. What is appropriate for the nurse to include in the patient's education? Select all that apply.

-Avoid using enemas -Avoid using sedatives -Take the prescribed medication before breakfast

A patient who underwent surgery for acromegaly complains of postoperative headache and running nose. What action should the nurse take to resolve the problems within 72 hours? Select all that apply.

-Check for glucose levels in nasal discharge -Encourage bed rest with the head elevated

A nurse is caring for a patient who underwent subtotal thyroidectomy because of the overproduction and release of thyroid hormone. Postoperative nursing interventions are important to prevent complications after surgery. Which nursing interventions should the nurse implement for safe, effective care? Select all that apply.

-Control postoperative pain by administering medication -Assess for signs of tetany secondary to hypoparathyroidism -Assess the patient every two hours for signs of bleeding or tracheal compression

The registered nurse is preparing to teach a group of nursing students about the pathophysiologic events associated with syndrome of inappropriate antidiuretic hormone (SIADH). Which events should the nurse include in the teaching plan? Select all that apply.

-Decreased serum osmolality -Increased water reabsorption -Occurrence of dilutional hyponatremia

A patient is suspected of having acromegaly. When gathering a health history, what questions would be important for the nurse to ask? Select all that apply.

-Do you snore? -Have you noticed an increase in your shoe size? -Have you experienced unusual thirst or excessive urination? -Have you experienced numbness or tingling in your fingers or hands?

A patient has been diagnosed with acromegaly and is suspected of having developed diabetes mellitus as a result of the increased growth hormone (GH). What clinical manifestations does the nurse document that correlate with the development of diabetes mellitus? Select all that apply.

-Increased thirst -Increased urination

The patient with systemic lupus erythematosus has been diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse expect to include in this patient's plan of care? Select all that apply.

-Limit fluids to 1000 mL per day -Keep the head of the bed at 10 degrees or less elevation

The nursing care of a patient who had a parathyroidectomy should include which actions? Select all that apply.

-Monitor intake and output -Ensure that intravenous (IV) calcium is available -Assess for numbness and tingling of the hands and mouth

A patient with pituitary adenoma underwent transsphenoidal hypophysectomy. What nursing actions are most effective for prevention of complications? Select all that apply.

-Monitoring the pupillary response - Elevating the head of the patient's bed -Observing the patient for any signs of bleeding -Monitoring extremity strength to detect neurologic complications

The nurse is assessing a patient for hyperthyroidism. What are the manifestations of hyperthyroidism? Select all that apply.

-Presence of bruits upon auscultation of the thyroid gland -Presence of goiter detected on palpation of the thyroid gland -Presence of clubbed and swollen fingers

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion in the acute care setting. What nursing interventions are important for this patient? Select all that apply.

-Restrict fluid intake to no more than 1000 mL/day -Implement seizure precautions and set the bed alarm. -Provide the patient with ice chips to decrease thirst.

A nurse is caring for a patient admitted for hyperthyroidism. What laboratory results will the nurse expect to see in the electronic chart to confirm hyperthyroidism? Select all that apply.

-Undetectable TSH levelUndetectable TSH level -Elevated free thyroxine (free T4) level -Low thyroid-stimulating hormone (TSH) level

Which factors should the nurse assess in a patient who is on desmopressin acetate (DDAVP)? Select all that apply.

-Weight -Mental status -Sodium levels

The patient has a prescription for levothyroxine 37.5 mcg. Available are 0.075 mg tablets. How many tablets should the nurse administer?

0.5 tablet

A patient is prescribed levothyroxine. To promote optimal absorption, the nurse should instruct the patient to take the medication at which time?

0600

The nurse determines that the patient who is receiving radioactive iodine therapy for the treatment of hyperthyroidism needs additional instructions when the patient makes which statement?

"I will need to take antithyroid drugs for three months after I begin RAI therapy."

Which patient statement indicates the need for further education regarding the management of both cardiac disease and hypothyroidism?

"I will use an enema for constipation."

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."

Which statement by the patient who is postoperative following a transphenoidal hypophysectomy indicates a need for further education?

"It is important that I brush my teeth every day."

A patient scheduled for a thyroidectomy is placed on potassium iodine. When the patient's family asks the nurse why this medication is needed, what is the nurse's best response?

"This medication will decrease the vascularity of the thyroid gland."

A patient diagnosed with acromegaly has developed peripheral neuropathy and asks what is causing the discomfort. What is the nurse's best response?

"You have developed the condition due to overgrowth of muscles and tissues."

A patient undergoes a physical examination and several diagnostic tests, upon which the patient is diagnosed with acromegaly. Which findings in the patient would require the nurse to prepare the patient for surgery? Select all that apply.

-Appearance of pituitary tumors -Increase in growth hormone (GH) concentration after oral glucose tolerance test

The nurse is caring for a patient undergoing radioactive iodine therapy in the outpatient setting. What instructions should the nurse provide to this patient? Select all that apply.

-Avoid preparing food for others. -Launder personal towels, bed linens, and clothes separately at home -Avoid being close to pregnant women or children for seven days after therapy

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

A patient with a severe pounding headache has been diagnosed with hypertension that is not responding to traditional treatment. What should the nurse expect as the next step in management of this patient?

A 24-hour urine collection for fractionated metanephrines

The nurse is educating patients about having a screening colonoscopy every three to four years, because they are at risk for developing colon polyps and colorectal cancer. What patient is at greatest risk for this complication?

A patient with acromegaly

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) who has muscle twitching, vomiting, severe abdominal cramps, and begins to have seizures. The nurse assesses a serum sodium level of 116 mEq/L. What is the priority nursing action for this patient?

Administer hypertonic saline solution slowly

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

Administer large volumes of saline and dextrose.

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

Aminoglutethimide

The nurse is caring for patients with thyroid cancer. The nurse recognizes that the one with the poorest prognosis is the patient with which type of cancer?

Anaplastic thyroid cancer

The nurse is caring for a patient diagnosed with a toxic nodular goiter with painless thyroiditis. The nurse suspects that the patient has an autoimmune disease based on what assessment finding?

Exophthalmos

Which clinical manifestation is a classic finding in Graves' disease?

Exophthalmos

Activity intolerance in a patient with hypothyroidism is related to what?

Fatigue

The nurse is caring for a hospitalized patient with bronze-colored skin and signs of hyperpigmentation, especially in a sun-exposed area. The clinical findings are as follows. Which drug should be prescribed by the primary health care provider in this case?

Fludrocortisone

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

Fluid intake

The nurse is caring for a patient with hyperaldosteronism. Which intervention will the nurse prioritize for this patient?

Frequent blood pressure monitoring

A patient is just returning to the surgical floor from the recovery room after undergoing a thyroidectomy. What is the nurse's priority nursing intervention?

Have a tracheostomy tray at the bedside.

Which finding is consistent with a diagnosis of hyperaldosteronism?

Hypernatremia

The nurse is caring for a patient who underwent removal of the thyroid gland (thyroidectomy) three days ago. The patient's serum chemistries reveal calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of 4.0 mg/dL. What condition do these findings indicate?

Hypocalcemia

Which is a clinical manifestation of Cushing syndrome?

Hypokalemia

Which nursing diagnostic statement is the highest priority for a patient with myxedema?

Hypothermia

A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition?

Hypothyroidism

A patient is suspected of having acromegaly. Which symptom should the nurse assess for in this patient?

Increase in shoe size

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

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) after a head injury. What condition does the nurse suspect that correlates with this disorder?

Increased intravascular volume

When caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH), it is important that the nurse implement which nursing action?

Initiate seizure precautions

The nurse is caring for a patient who underwent transsphenoidal hypophysectomy to treat acromegaly. Which is the best nursing action to prevent leakage of cerebrospinal fluid?

Instructing the patient to avoid vigorous coughing, sneezing, and straining at stool

The nurse is caring for a patient with a history of hyperthyroidism who was admitted into the hospital with a kidney infection. It is most important that the nurse notify the health care provider if noting which physical sign or symptom?

Jugular vein distention

The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for what manifestation?

Lethargy and weakness

During surgery for Cushing syndrome, a patient develops hypertension, which has a potential to increase the risk of hemorrhage. What should be done to stop the risk of hemorrhage?

Maintain normal levels of endogenous hormones during surgery

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

The nurse expects that which medication will be included in the drug therapy for a patient that has a thyroxine level of 14 µg/dL?

Methimazole

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

Mifepristone

The nurse is caring for a patient who underwent a transsphenoidal hypophysectomy. What is the most important nursing intervention for this patient?

Monitor pupillary response and speech patterns.

Which nursing intervention is most important for a patient with diabetes insipidus?

Monitoring fluid intake and output

A patient diagnosed with acromegaly is to receive medication to block the hepatic production of insulin-like growth factor-1. What medication will the nurse prepare to administer to the patient?

Pegvisomant

The nurse is caring for a patient who is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention would promote a reduction in the release of antidiuretic hormone (ADH)?

Positioning the head of the bed flat

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

A patient has a dysfunction of the pituitary gland. Which hormone secretion does the nurse recognize may be altered in this patient?

Prolactin

The nurse is administering intravenous glucose solution to a patient who is suffering from diabetes insipidus. What parameters would the nurse monitor for the management of osmotic diuresis?

Serum glucose levels

A patient reports "eye problems". On assessment of this patient, the nurse notes exophthalmos. What other abnormal assessments should the nurse expect to find in this patient?

Systolic hypertension and increased heart rate

The nurse is obtaining a history and physical on a patient with acromegaly who reports visual changes. What should the nurse assess in this patient?

The function of cranial nerve II

A patient has undergone surgery for acromegaly. After surgery, the patient is experiencing severe headache. What action should be taken to provide relief from the headache?

The head of the bed should be elevated to 30-degree angle.

The nurse informs a patient that has had a hypophysectomy for removal of a pituitary tumor to avoid vigorous coughing and sneezing. What explanation does the nurse give the patient for these instructions?

To prevent cerebrospinal fluid leakage

A patient has a serum sodium level of 134 mEq/L, an osmolality less than 280 mOsm/kg, and the urine specific gravity is greater than 1.025. Which medication is most beneficial for this patient?

Tolvaptan

Which medication does the nurse expect to be prescribed for a patient diagnosed with metastatic thyroid cancer that has a calcitonin level of 25 pg/mL?

Vandetanib

Which is a sign of syndrome inappropriate antidiuretic hormone (SIADH)?

Increased intravascular volume

In developing a teaching plan for the patient with exophthalmos, the nurse understands that the highest priority is placed on

Preventing corneal injury

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

What does the nurse include in the teaching plan for the client who is receiving radioactive iodine?

Towels that are used by the patient should not be used by other family members.

What complications may arise if pheochromocytoma is left untreated?

Diabetes mellitus

Which endocrine problem is more common in men than in women?

Ectopic adrenocorticotropic hormone production

A patient diagnosed with hyperthyroidism presents with neck nodules that are less than 3 cm in size. Biopsy reveals the nodules are non-malignant. Which treatment does the nurse expect for this patient?

Endoscopic thyroidectomy

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

Excessive secretion of adrenocorticosteroid hormones

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

Phenoxybenzamine

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

"Avoid grapefruit juice."

Which disease is treated with corticosteroidal hormonal therapy?

Adrenal insufficiency

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

Adrenocorticosteroid replacement therapy

Adrenocortical insufficiency develops secondary to inadequate secretion of which pituitary hormone?

Adrenocorticotropic hormone (ACTH)

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

Adrenocorticotropic hormone (ACTH)

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

Blood glucose

A nurse completes an assessment and notes that a patient's thyroid gland is enlarged. With which condition is this finding consistent?

Goiter

Which condition shows a clinical presentation of purplish red striae?

Hyperfunction of glucocorticoids

Which statement is true about pheochromocytoma?

Severe pounding headaches and profuse sweating are clinical features

A patient with a pituitary tumor has developed excessive height, and increased hat size and shoe size. Which hormone does the nurse determine is secreting excessively?

Somatotropin

While assessing a patient with suspected Cushing's syndrome, of what most prominent clinical manifestation is the nurse aware?

Weight gain, including truncal obesity

A patient who had surgery for the treatment of acromegaly asked about the possibility of becoming pregnant. When responding to the patient, from what knowledge should the nurse base the rationale?

There will be a permanent loss of hormones

Which parameter would indicate the optimal intended effect of therapy with levothyroxine?

Thyroid-stimulating hormone (TSH) of 1.5 mIU/L

A nurse reviewing the recent medical history of a patient with hypoparathyroidism expects to find a history of:

Thyroidectomy

The patient experiencing thyrotoxicosis asks the nurse why he or she is being given propranolol. What is the most accurate answer to the patient's question?

To block the sympathetic nervous system response to excess thyroid hormone

A patient with aldosteronism who has undergone unilateral adrenalectomy is advised to monitor blood pressure (BP) frequently. What is the most appropriate reason behind monitoring BP?

To check whether the blood pressure is controlled or not after surgery

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

What is the dosage schedule for the administration of glucocorticoids?

Two-thirds of a dose in the morning and one-third in the afternoon

Which test is more reliable to diagnose pheochromocytoma?

Urinary creatinine

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 is admitted to the intensive care unit (ICU) with multiple organ abnormalities and a decreased level of consciousness. The nurse notes that the patient has a history of hypothyroidism. What interventions are appropriate to be included on the patient's plan of care? Select all that apply.

-Administering thyroid hormone intravenously -Monitoring cardiovascular status continuously

Which type of adrenal disorder is illustrated?

Cushing syndrome

The nurse reviews lab values for a patient who underwent thyroidectomy 48 hours ago. Which finding is of most concern?

Decreased serum calcium

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 has developed diabetes insipidus. Arrange the events in the order they occur in this patient.

-Decrease in antidiuretic hormone -Increase in serum osmolality -Decrease in intravascular fluid volume -Decrease in water reabsorption

Which clinical manifestations does the nurse expect during the assessment of a hospitalized patient experiencing exophthalmos? Select all that apply.

-Dyspnea -Cardiac hypertrophy -Bounding, rapid pulse

What are the characteristic signs and symptoms of hyperparathyroidism? Select all that apply.

-Fractures -Osteoporosis -Nephrolithiasis

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

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

Which type of health education should a nurse provide to a patient who is on corticosteroid therapy? Select all that apply.

-Restrict sodium intake. -Maintain a high-protein diet -Ensure adequate rest and sleep

Which clinical manifestations does the nurse expect to assess in a patient that is diagnosed with hyperthyroidism? Select all that apply.

-Weight lossWeight loss -Protrusion of the eye balls -Elevated blood pressure

The patient with small cell lung cancer experiences a sudden 5-pound weight gain without edema and a decreased urinary output. Serum sodium is 128 mEq/L. Which strategy does the nurse anticipate will be prescribed for the patient?

1000 mL per day fluid restriction

What level of urine cortisol indicates Cushing syndrome?

130 mcg/24 hr

The nurse is caring for a patient who is postoperative following a thyroidectomy. A priority of the patient's nursing care includes which action?

Assessment of Chvostek's sign

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

Autoimmune polyglandular syndrome

The nurse is caring for a patient with hyperthyroidism. What should the nurse teach the patient about dietary intake?

Avoid highly seasoned and high-fiber foods

A patient is instructed to ingest 75 g of glucose orally as a part of an oral glucose tolerance test. In addition, growth hormone measurements are taken consecutively at 30, 60, 90, and 120 minutes. Glucose levels and growth hormone levels are found to be constant during the test. What does the nurse infer from these findings?

Acromegaly

A patient is suffering from numbness and a "pins and needles" sensation in the thumb, middle, and index finger, especially at night. Which condition would the nurse suspect in the patient?

Acromegaly

Which condition can result if hypersecretion of growth hormone (GH) occurs after epiphyseal plate closure?

Acromegaly

The nurse is caring for a patient diagnosed with nephrogenic diabetes insipidus not responding to primary treatment. Which intervention does the nurse expect to be useful in increasing the renal response to antidiuretic hormone?

Administering indomethacin

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

Adrenal hemorrhage

A patient with hypertension undergoes testing on his or her serum electrolyte and plasma aldosterone levels. The laboratory findings showed plasma 18-hydroxycorticosterone levels as 60 ng/dL, potassium level as 2.5 mEq/L, and sodium level as 150 mEq/L. What could be the diagnosis?

Conn's syndrome

What is the clinical manifestation of Addison's disease?

Delusions

A 70-year-old man was admitted to an inpatient unit for a closed head injury after falling down a flight of stairs. The patient has been calling for the nurse every half hour requesting more water to drink and to use the urinal. The unlicensed assistive person (UAP) recorded urine output every hour for the past five hours as 500, 400, 600, 250, and 300 mL. Along with the urine output, the urinalysis revealed a specific gravity of 1.000 on each specimen. Because the patient had a head injury, the primary healthcare provider determines that the patient has central diabetes insipidus (DI). What does the nurse expect the primary healthcare provider will order for the patient?

Desmopressin acetate (DDAVP)

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

The nurse assesses a patient that presents with eye protrusion. The patient states, "My eyes are dry and irritated." Based on these data, the nurse expects that what diagnosis will be made?

Graves' disease

Which hormone has both mineralocorticoid and glucocorticoid properties?

Hydrocortisone

Which condition may be linked to Conn's syndrome?

Hyperaldosteronism

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

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 preparing to administer levothyroxine to a patient newly diagnosed with hypothyroidism. The patient's resting heart rate is 110. Which initial action should the nurse take?

Obtain a blood pressure measurement

A patient with adrenocortical insufficiency is prescribed hydrocortisone. Which drugs should be avoided in the patient's prescription?

Oral hypoglycemics, anticoagulants, and nonsteroidal antiinflammatory drugs (NSAIDs)

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 sends the clear nasal drainage of a patient who underwent transphenoidal hypophysectomy for testing. The laboratory readings reveal glucose levels at 40 mg/dL. What does the nurse infer from this finding?

The patient is at an increased risk for meningitis

The nurse is providing discharge instructions to a patient with diabetes insipidus. Which instructions regarding desmopressin acetate would be most appropriate?

The patient should alternate nostrils during administration to prevent nasal irritation.

A patient who is diagnosed with hypothyroidism and coronary artery disease (CAD) states to the nurse, "I am constipated. My spouse wants me to try an enema to help relieve my discomfort." The nurse educates the patient that using enemas is contraindicated due to the diagnosis. Which is the rationale for this contraindication?

Vagus nerve stimulation