Nurs 201 Endocrine

A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client? "Take this medication until your symptoms are gone and then discontinue." "Tremors, nervousness, and insomnia may indicate your dose is too high." "Symptoms improve immediately after starting the medication." "The medication decreases the overproduction of the thyroid hormone thyroxine."

"Tremors, nervousness, and insomnia may indicate your dose is too high."

A nurse is reviewing the lab results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? A client who has a vitamin D of 25 ng/mL A client who has a magnesium of 1.8 mEq/L A client who has a calcium of 9.8 mg/dL A client who has a phosphate of 5.7 mg/dL

A client who has a phosphate of 5.7 mg/dL This level is above the expected reference range of 3.0 to 4.5 mg/dL. Phosphorus levels are increased in a client who has hypoparathyroidism.

A nurse is planning care for a client who is postop following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Instruct the client to deep breathe every 4 hr. Check the client's voice every 2 hr. Place the head of the client's bed in the flat position. Hyperextend the client's neck.

Check the client's voice every 2 hr. The nurse should assess the client's voice every 2 hr to monitor for hoarseness, which is a manifestation of laryngeal nerve damage.

A nurse is caring for a client who is 1 day postop following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? Chvostek's sign Babinski's sign Brudzinski's sign Kernig's sign

Chvostek's sign

A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse execpt? Flaccid muscles Client report of numbness in his hands Negative Chvostek's sign Client report of anorexia

Client report of numbness in his hands Numbness and tingling in the client's hands and feet are manifestations of hypoparathyroidism due to hypocalcemia.

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicate a therapeutic response to the medication? Decrease in level of thyroxine (T4) Increase in weight Increase in hr of sleep per night Decrease in level of thyroid stimulating hormone (TSH).

Decrease in level of thyroid stimulating hormone (TSH).

A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following lab results? Decreased thyroid-stimulating hormone (TSH) level Decreased triiodothyronine (T3) level Decreased thyroxine (T4) level Decreased thyroid-stimulating immunoglobulins (TSI) percentage

Decreased thyroid-stimulating hormone (TSH) level

A nurse is assessing a client who has myxedema. Which of the following findings should the nurse expect? Diarrhea Facial edema Tachycardia Heat intolerance

Facial edema Facial edema is an expected finding of myxedema, which is a severe form of hypothyroidism. A client who has myxedema typically experiences non-pitting edema everywhere, especially around the eyes and in the hands and feet.

a nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations? Sensitivity to cold Constipation Frequent mood changes Weight gain of 4.5 kg (10 lb) in 3 weeks

Frequent mood changes Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones that regulate the metabolic rate. Clients experience emotional lability that fluctuates between emotional hyperexcitability and irritability. They often cannot sit quietly.

A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect? Hyperpigmentation Intention tremors Hirsutism Purple striations

Hyperpigmentation

A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the nurse expect? Weight loss Hypotension Diaphoresis Hyperpigmentation

Hyperpigmentation Hyperpigmentation, bruising, and striae or stretch marks, are manifestations of Cushing's syndrome.

NGN: A nurse is caring for a female client. Physical Examination: Client reports an increase in appetite and an 8 lb weight loss over a 4-week period. Client has bilateral exophthalmos and reports blurred vision. Thyroid gland is soft with an audible bruit. Skin is warm and moist. Client reports heart palpitations, apical heart rate is rapid and regular. Client reports 2 to 3 bowel movements/day, increased fatigue, difficulty concentrating, and insomnia. Vital Signs: Temperature 38.1º C (100.6º F)Blood pressure 168/70 mm HgHeart rate 110/minRespiratory rate 24/minOxygen saturation 95% on room air Diagnostic Results Fasting glucose 150 mg/dL (70 mg/dL to 110 mg/dL)Serum T3 220 ng/dL (70 ng/dL to 205 ng/dL)Serum T4 (total) 20 mcg/dL (5 mcg/dL to 12 mcg/dL)Hct 38% (37% to 47%)

Hyperthyroidism 1. Ask for a prescription for artificial tears. 2. Provide a calm environment 1. Monitor T3 and T4 2. Check client's temperature and blood pressure frequently

NGN: A nurse is caring for a 58-year-old client in an outpatient clinic. Medical History: 58-year-old client in clinic for annual physical. Ht: 5 ft 1 in, Weight: 180 lbs. BMI: 31. Alert and oriented x3. Client states they have been more fatigued over past 6 months, attributing it to increased workload at job. Reports non-adherence to prescribed low cholesterol diet and not exercising regularly. Has sedentary job. Reports blurry vision, increased water intake, and increased urination over past several months. Does not report pain or discomfort. Client has history of hypertension and hyperlipidemia. Vital Signs Temperature 36.3° C (97.4° F) Heart rate 78/min Respiration rate 16/min BP 134/84 mm Hg Oxygen saturation 98% room air

Hypothyroidism Actions to take- 1. "check client's sense of touch" 2. "Obtain a glucose level" Parameters to Monitor- 1. "monitor lifestyle modifications" 2. "glycosylated hemoglobin"

A nurse is assessing a client who is receiving liothyroxine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication? Decrease in appetite Increase in weight Increase in energy Decrease in body temperature

Increase in energy An increase in energy is a therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations.

A nurse is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? Limit intake of potassium-rich foods. Restrict sodium intake. Increase carbohydrate intake. Decrease protein intake.

Restrict sodium intake

A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? Radioactive iodine Levothyroxine Sumatriptan Levofloxacin

Levothyroxine

A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism? A client who has a butterfly rash on his face. Moon face A client who has a positive Chvostek's sign. A client who has muscle hypertrophy.

Moon face

A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? SATA Alopecia Tremors Moon face Purple striations Buffalo hump

Moon face Purple striations Buffalo hump ATI said ALOPECIA too, but per prof it's wrong.

A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Impaired skin integrity Fluid retention Pathologic fractures Dysphagia

Pathologic fractures A client who has hyperparathyroidism is at risk for pathological fractures due to the release of calcium and phosphate into the blood, which reduces bone density and places the client at risk for pathologic fractures.

A nurse is caring for a client who is in a myxedema coma. Which of the following actions should the nurse take? Turn the client ever 4 hr. Check the client's blood pressure every 2 hr. Initiate measures to cool the client. Place the client on aspiration precautions.

Place the client on aspiration precautions.

A nurse is assessing a client who is admitted with hyperthyroidism. The client reports a weight loss of 5.4 kg(12lbs) in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. Which of the following actions should the nurse take to prevent a thyroid crisis? Provide a quiet, low-stimulus environment. Administer aspirin as prescribed for any sign of hyperthermia. Keep the client NPO. Observe the client carefully for signs of hypocalcemia.

Provide a quiet, low-stimulus environment.

A nurse is reviewing the lab results for four clients. The nurse should recognize that which of the following clients has a manifestation of primary hyperparathyroidism? The client who has a decreased calcium level The client who has an increased magnesium level The client who has a decreased parathyroid hormone level The client who has an increased phosphorous level

The client who has an increased magnesium level

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values? TSH Free T4 Serum T4 Serum T3

Thyroid stimulating hormone (TSH)

A nurse is caring for a client who is 1 day postop following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take? Check the pedal pulses. Verify the most recent calcium level. Request prescription for a relaxant. Administer an oral potassium supplement.

Verify the most recent calcium level.

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? Provide a low-carbohydrate diet. Weigh the client daily. Administer oral corticosteroids. Restrict fluid intake.

Weigh the client daily. Addison's disease is an endocrine disorder that causes weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the skin. Obtaining the client's daily weight will alert the nurse that dehydration is developing, which could indicate an impending crisis.

A nurse is monitoring a client who is postop following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Airway patency Temperature Urination Pain control

airway patency

A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? SATA Assess blood glucose level Assess for neck vein distention Monitor for an irregular heart rate Monitor for postural hypotension Weigh the client daily

assess blood glucose level ? Cushing's syndrome affects blood glucose levels by causing increased release of glucose from the liver and decreased sensitivity of insulin receptors. This can result in elevated blood glucose levels.

A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Drowsiness Bradycardia Dry skin Heat intolerance

heat intolerance

A nurse is assessing an adolescent who has an exacerbation of Graves' disease. Which of the following findings should the nurse expect? Weight gain Bradycardia Lethargy Heat intolerance

heat intolerance

A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? Insomnia Constipation Drowsiness Hypoactive deep-tendon reflexes

insomnia & tachycardia, and hyperthermia.

A nurse is caring for a client who is 8 hr postop following a subtotal thyroidectomy. In which of the following positions should the nurse keep the client? High Fowler's with neck extended High Fowler's with neck in a neutral position. Semi-Fowler's with neck extended Semi-Fowler's with neck in a neutral position

semi-Fowler's with neck in a neutral position

A nurse is caring for a client who has total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect? Tingling of the extremities Hypoactive deep tendon reflexes. Shortened QT intervals. Constipation

tingling of extremities.

A nurse is assessing a client who has hypothyroidism. The nurse should expect which of the following findings? Exophthalmos Palpitations Weight gain Diaphoresis

weight gain

A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? Ripe bananas Poached eggs Whole grains Baked chicken

whole grain