Ch 45 Assessment and Management of Patients with Endocrine Disorders

Hypocalcemia is associated with which of the following manifestations?

Muscle twitching

A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?

Acromegaly

A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?

Pressure on the optic nerve

Patients with hyperthyroidism are characteristically:

Sensitive to heat

A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?

Tracheostomy set

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

Gigantism

Which hormone would be responsible for increasing blood glucose levels by stimulating glycogenolysis?

Glucagon

The adrenal cortex is responsible for producing which substances?

Glucocorticoids and androgens

Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease?

Have regular follow-up care.

For a client with Graves' disease, which nursing intervention promotes comfort?

Maintaining room temperature in the low-normal range

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?

Calcium gluconate

Which diagnostic test is done to determine a suspected pituitary tumor?

Computed tomography

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake."

A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder?

Blood pressure varying between 120/86 and 240/130 mm Hg

Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?

Bulging forehead

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following?

Detecting evidence of hormone hypersecretion

A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8-pound weight loss since admission. What condition does the nurse expect the client to be tested for?

Diabetes insipidus (DI)

A group of students is reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla?

Epinephrine

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

Exophthalmos

A nurse should perform which intervention for a client with Cushing's syndrome?

Explain that the client's physical changes are a result of excessive corticosteroids.

A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test?

Fine-needle biopsy of the thyroid gland

A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine condition should the nurse expect the health care provider to diagnose?

Goiter

A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called?

Hypophysectomy

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.

Hypothermia Hypotension Hypoventilation

The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?

Iodine

Which intervention is the most critical for a client with myxedema coma?

Maintaining a patent airway

Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?

Observe stool color.

Which glands regulate calcium and phosphorous metabolism?

Parathyroid

A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction?

Parathyroid gland

A client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood?

Pineal gland, melatonin

Which of the following glands is considered the master gland?

Pituitary

Parathyroid hormone (PTH) has which effects on the kidney?

Stimulation of calcium reabsorption and phosphate excretion

A nurse explains to a client with thyroid disease that the thyroid gland normally produces:

T3, thyroxine (T4), and calcitonin.

Which laboratory test results should a nurse expect to find in a client diagnosed with Hashimoto's thyroiditis?Which laboratory test results should a nurse expect to find in a client diagnosed with Hashimoto's thyroiditis?

T4, 22 µg/dl; T3, 200 ng/dl; TSH 0.1 mIU/ml

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Tetany

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?

The functioning of endocrine glands

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect:

a blood pressure of 176/88 mm Hg. Pheochromocytoma causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. It isn't associated with hypotension, hypoglycemia, or bradycardia.

A nurse is performing an examination and notes that the client exhibits signs of exophthalmos. What has the nurse observed?

abnormal bulging or protrusion of the eyes

Exophthalmos

abnormal protrusion of the eyeball

During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted?

decrease in hormonal levels

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:

decreased body temperature and cold intolerance.

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands?

four

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:

phosphorus.

A nurse is caring for a client with hypoparathyroidism. During assessment, the nurse elicits a positive Trousseau's sign. What does the nurse observe to verify this finding?

hand flexing inward

A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms?

hyperpituitarism

Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells?

kidneys

A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function?

metabolic rate

Cardiac effects of hyperthyroidism include

palpitations.

A client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, the nurse expects to administer:

phentolamine (Regitine).

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?

pituitary disorder