CM1: Med Surg test THREE - endocrine

which manifestations are exhibited with SIADH? increased BUN and HoTN hyperkalemia and poor skin turgor hyponatremia and decreased UOP polyuria and increased specific gravity

hyponatremia and decreased UOP

a client is admitted with a head injury and has large amounts of clear urine in bag. Which physiological response is possibly causing this? increased glucose deficient renal perfusion inadequate ADH secretion excessive IV fluids

inadequate ADH secretion

Excess thyroid hormones result in a ________________ metabolic rate

increased

which manifestation in a client with SIADH would the nurse expect to find? preservation of salt retention of water decrease of vasopressin presence of pedal edema

retention of water

Hirustism (excessive hair growth) is r/t which endocrine disorder?

Cushings disease

what is the characteristic difference between DM1 and DM2?

DM 1 has a more rapid onset

ketoacidosis is a common complication of which type of diabetes?

DM1

Exophthalmos is a symptom of which disease?

Graves

which cause of tremors, pallor, and diaphoresis would be suspected in a client with DM1? overeating viral infection aerobic exercise missed insulin dose

aerobic exercise

T3 & T4 control the ____________ which can alter the function of almost every body system

basal metabolic rate

while obtaining a client's health history, which factor would the nurse identify as predisposing the client to DM2? having DI eating low-cholesterol foods being 20lbs over weight drinking alcohol daily

being 20lbs over weight

PTH increases bone _________ which stimulates the increase of ___________

breakdown serum calcium

antidiabetic meds can cause ____________

hypoglycemia

which finding would be expected in a client with a history of hypothyroidism? select all a. cold intolerance b. lethargy and fatigue d. 15lb weight gain e. HR 59

cold intolerance lethargy and fatigue 15lb weight gain HR 59

which manifestation would the nurse include when teaching a client about ketoacidosis? select all a. confusion b. hyperactivity c. excessive thirst d. fruity breath e. decreased urine output

confusion excessive thirst fruity breath

which symptom would the nurse monitor for in a client with Addison's disease? pyrexia hypertension hirsutism hypoglycemia

hypoglycemia

which outcome would be expected after a client received treatment for Cushing's disease? increased cortisol levels increased Na+ levels decreased BG levels decreased serum Ca+ levels

decreased BG levels

patients with DM1 are insulin __________

dependent

deficient ADH from the posterior pituitary results in __________

diabetes insipidus

which clinical finding would the nurse expect when assessing a client with hyperthyroidism? select all a. diarrhea b. listlessness c. weight loss d. bradycardia e. decreased appetite

diarrhea cweight loss

a decreased urinary output as a result of SIADH causes what to happen to the electrolytes?

dilution

hyperglycemia acts as an osmotic ___________, resulting in dehydration

diuretic

which skin condition would the nurse expect when preforming a physical assessment on a client with a history of hypothyroidism? dry moist flused smooth

dry

Which symptoms would be observed in a client with hyperglycemia & ketoacidosis? select all a. irritability b. dry skin c. diaphoresis d. increased thirst e. deep, rapid breathing

dry skin increased thirst deep, rapid breathing

What causes Cushing's syndrome?

excess cortisol

which factors can predispose a client with DM1 to a diabetic ketoacidotic coma? select all a. too much insulin b. getting too much exercise c. excessive emotional stress d. running a fever w/ the flu e. eating fewer calories than prescribed

excessive emotional stress & running a fever w/ the flu

which manifestation may indicate that the client with DM1 has insulin-induced hypoglycemia? select all a. excessive hunger b. weakness c. diaphoresis d. excessive thirst e. deep respirations

excessive hunger weakness diaphoresis

when assessing a client with DI which s/s would the nurse anticipate finding? select all a. excessive thirst b. increased BG c. dry mucous membranes d. increased BP e. decreased serum osmolarity f. decreased specific gravity

excessive thirst dry mucous membranes decreased specific gravity

excessive thirst is r/t hyperglycemia bc of ____________

fluid shifts and excessive glucose being excreted in kidneys

s/s of DKA

fruity breath frequent urination n/v belly pain weakness/fatigue

emotional stress stimulates the SNS which releases ___________ which increases ____________

glucocorticoids blood glucose

Cushing's disease affects ___________ and results in reduced glucose uptake by tissues and increased blood ________

glucose metabolism glucose levels

Kussmaul respirations are associated with _________glycemia because the body is trying to get rid of Co2 to compensate for metabolic acidosis

hyper

moist, smooth skin occurs with which type of thyroid issue?

hyperthyroidism

Tetany is a result of ___________

hypocalcemia

which effect does increased PTH have on bones and electrolytes? select all a. increased bone breakdown b. increased serum Ca+ c. increased Na+/phosphorus excretion d. increased absorption of Ca+ and phosphorus e. increased net release of Ca+ and phosphorus

increased bone breakdown increased serum Ca+ increased net release of Ca+ and phosphorus

which would the nurse include in teaching a teen about DM1? insulin therapy prophylactic antibiotics blood glucose monitoring oral hypoglycemic agents adherence to treatment regimen

insulin therapy blood glucose monitoring adherence to treatment regimen

Cushing's disease causes what to happen to your BP?

it goes up r/t fluid & sodium retention

a 15 year old is found to have DI. Which teaching would the nurse include? it doesn't always require insulin it involves early vascular changes it occurs more often in obese teens it has a more rapid onset than DM2

it has a more rapid onset than DM2

which statement is correct regarding calcitonin? it's secreted by follicular cells it's actions are opposite to that of PTH it decreases phosphorus levels by increasing bone reabsorption it works along with thyroid hormone to maintain normal Ca+ levels

it's actions are opposite to that of PTH

Dm1 is often first diagnosed during an episode of acute __________

ketoacidosis

which complication associated with Dm1 should the nurse include in the teaching plan for the parent of a newly diagnosed kid? obesity ketoacidosis resistance to treatment hypersensitivity to other meds

ketoacidosis

a client with DM1 for 25 years states "I have been really bad for the past 15 years. I don't watch my diet and don't control it well". Which common complication might you expect to find? select all a. leg ulcers b. loss of visual acuity c. thick, yellow toe nails d. increased growth of body hair e. decreased sensation in feet

leg ulcers loss of visual acuity thick, yellow toe nails decreased sensation in feet

the focus for patients with DI is _______________-

maintaining fluid and electrolytes

loss of the thyroid gland will upset thyroid hormone balance and may cause _____________

myxedema

do DM1 clients use hypoglycemia agents?

no, bc they are ineffective in stimulating insulin secretion

which responses would the nurse expect a client experiencing hypoglycemia to exhibit? select all a. nausea b. palpitations c. tachycardia d. nervousness e. warm, dry skin f. increased respirations

palpitations tachycardia nervousness

which purpose would KCl add to the IV solution of a client with DKA? treats hyperpnea prevents flaccid paralysis prevents hypokalemia treats cardiac dysrhythmias

prevents hypokalemia

which interventions would the nurse implement in caring for a client with diabetes insipidus after a head injury? select all a. provide adequate fluids b. report an increase in specific gravity c. administer prescribed erythromycin d. assess for & report changes in neuro status e. monitor for constipation, weight loss, hypotension, and tachycardia

provide adequate fluids assess for & report changes in neuro status monitor for constipation, weight loss, hypotension, and tachycardia

when you give insulin for DKA it causes the potassium ions to ________ leading to _________

reenter the cells hypokalemia

which findings would the nurse associated with cushing's disease? select all a. round face b. dependent edema in feet c. increased fatty deposition in extremities d. thin, translucent skin w/ bruising e. increased fatty deposition in neck & back

round face dependent edema in feet thin, translucent skin w/ bruising increased fatty deposition in neck & back

the nurse is providing immediate post-op care to a client with a thyroidectomy. The nurse would monitor them for which manifestation? urinary retention restlessness decreased BP signs of respiratory obstruction

signs of respiratory obstruction

what electrolyte is elevated in hypercortisolism?

sodium

which instruction would be included in the discharge plan for a client status post-total thyroidectomy? take T replacement meds be aware of s/s of dehydration avoid all over the counter meds report signs of hypoglycemia

take T replacement meds

The nurse is educating a newly diagnosed DM2 client on oral diabetic meds. Which should she include? select all a. take a finger prick test before each meal b. you don't need to follow a diet c. s/s of hypoglycemia d. how to administer regular insulin

take a finger prick test before each meal s/s of hypoglycemia

which complication would the nurse be concerned about if there is a removal of the parathyroid glands during a thyroidectomy? tetany myxedema hypovolemic shock adrenocortical stimulation

tetany

what causes DKA?

the body isn't able to produce enough insulin so it breaks down fat instead

Graves disease is characterized by the overproduction of ____________

thyroid hormones

which skin condition would the nurse expect when performing a physical assessment on a client with a new diagnosis of hyperthyroidism? select all a. warm b. moist c. pale d. smooth e. coarse f. dry

warm moist smooth