EXAM 3 303

A nurse is providing discharge teaching to a client who has HIV. Which of the instructions about infection prevention should the nurse include? SATA A. Avoid large gatherings of people B. Clean toothbrush by running through the dishwasher C. Change pet litter boxes with disposable gloves D. Consume fresh fruit and raw vegetables E. Avoid digging in the garden

A. Avoid large gatherings of people B. Clean toothbrush by running through the dishwasher E. Avoid digging in the garden (avoid crowds to reduce risk of infection, toothbrush in dishwasher or rinsing the toothbrush with bleach followed by hot water is also effective at destroying bacteria on the toothbrush, digging in dirt puts the client at risk for infection)

Rapid-acting insulin

Administer before meals Onset is rapid 10-30 min

When should you do diabetic screening?

BMI over 25 and one of the following: First-degree relative who has diabetes mellitus Age 45 or older Report of sedentary lifestyle History of vascular disease, polycystic ovary syndrome, gestation diabetes, or giving birth to an infant weighing more than 9lb African, hispanic, asian, american indian, or pacific islander Blood pressure consistently greater than 140/90 HDL less than 35 Triglyceride level greater than 250

Intermediate insulin

Between meals and at night Contains protamine (a protein_ which causes a delay in the insulin absorption or onset and extends the duration of action of the insulin

The nurse is teaching a group of clients with diabetes mellitus about foot care. Which of the following information should the nurse include? SATA A. Dry the feet vigorously with a towel after bathing B. Use an OTC kit to treat corns and calluses C. Use cotton or lambs wool to separate overlapping toes D. Wash the feet with lukewarm water E. Wear hard-sole shoes and do not go barefoot

C. Use cotton or lambs wool to separate overlapping toes D. Wash the feet with lukewarm water E. Wear hard-sole shoes and do not go barefoot (option A clients should gently pat the feet dry, particularly between the toes. Using a moisturize can prevent dry and cracked skin but should not be applied between the toes, option B to prevent further tissue damage the clients should not use OTC products or blades on cuts or lesions. Clients should report any sores or abnormalities to the health care provider)

What is low specific gravity mean in urine?

Caused by drinking too much water, severe kidney disease, diuretic use -head trauma, heart condition, kidney problem, metabolic disorder

A nurse is planning care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care? A. Check the clients blood glucose for hypoglycemia B. Check the clients urine specific gravity C. Weight the client weekly D. insert an indwelling urinary catheter for the client

Check the clients urine specific gravity The nurse should check the clients urine specific gravity for fluid volume overload

The nurse is talking with a client who reports daily fatigue and recent weight gain despite eating less. The nurse should ask if the client is also experiencing which of the following symptoms? SATA A. cold intolerance B. Constipation C. Fever D. Menstrual irregularities E. Night sweats F. Tachycardia

Cold intolerance Constipation Menstrual irregularities

How do you manage Rheumatoid Arthritis?

DMARDS Corticoidsteroids Methotrexate Early referral to a rheumatologist Rest and physical therapy Surgery

A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider? A. Nausea and vomiting B. Decreased hemoglobin C. Decreased appetite D. Anxiety

Decreased hemoglobin Zidovudine can cause severe anemia and neutropenia from bone marrow suppression resulting in hematologic toxicity

Hypoglycemia treatment (EMERGENT)

Dextrose 50% IV Glucagon: IV, IM, SC Used to treat hypoglycemia and increase gluconeogenesis

During anaphylaxis you need to give the client IV medication for itching and urticaria, what medication do you give?

Diphenhydramine also known as Benadryl

What labs do you check for Rheumatoid arthritis?

ESR(which is elevated) ANA: + in 1/5 patients Synovial aspirate with inflammatory changes

A nurse is assessing a clinet who has kaposi's sarcoma. Which of the following findings should the nurse expect? A. Nonproductive cough, fever, and shortness of breath B. Lesions on the retina that produce blurred vision C. Onset of progressive dementia D. Reddish-purple skin lesions

Reddish-purple skin lesions

Short insulin

Regular/ HUMULIN R Onset: 30 mins to 1 hour Peak 1-5 hours Duration 6-10

A nurse is teaching a client who has human immunodeficiency virus (HIV) about the early manifestations of acquired immune deficiency syndrome (AIDS). Which of the following statements should the nurse include in the teaching? A. You can expect a persistent fever and swollen glands B. You can expect an elevated WBC count C. You can expect increased blood pressure and edema D. you can expect weight gain

You can expect fever and swollen glands

A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching? A. You should exercise during a peak insulin time B. Wear a medical alert identification tag when you exercise C. Exercise can decrease the effects of insulin and cause the blood glucose levels to increase D. You will get the most benefit from exercise when you glucose levels are higher than normal

wear a medical alert tag when you exercise in the event of a hypoglycemic response because exercise can potentiate the effects of insulin and cause the blood glucose levels to decrease

During anaphylaxis you need to maintain the clients blood pressure what do you do?

-Place the client in the recumbent position with the legs elevated - Give the client normal saline rapid bolus 1-2 L -Maintain blood pressure with fluids, volume expanders, and vasopressors such as dopamine

Long acting insulin

Administer once a day at the same time Glargine insulin forms microprecipirates that dissolves slowly over 24 hr and maintains a steady blood sugar level with no peaks or troughs Although it does not have a peak the duration is dose-dependent administer glargine and detemir subcutaneous and NEVER IV

In diabetes insipidus what happens?

Diabetes insipidus is caused by damage to the hypothalamus or pituitary gland as a result of cranial surgery, an infection, or tumor. In this condition an inadequate amount of antidiuretic hormone is released and results in polyuria meaning there is an overproduction of urine. Specific gravity is low (1.001 to 1.003)

A nurse is assessing a client who has Graves disease. Which of the following findings should the nurse expect the client to display? A. Constipation B. Cold intolerance C. Difficulty sleeping D. Anorexia

Difficulty sleeping The client who has Graves disease can have difficulty sleeping and anxiety due to the overproduction of thyroid hormone

What are the manifestations that indicate the onset of AIDS?

Fever SWollen glands Diarrhea Weight loss fatigue

What is propylthiouracil used for and what does it do?

It blocks thyroid production and is used for treatment of hyperthyroidism

What is phenochromocytoma?

It is a tumor of the adrenal gland that causes excess release of the catecholamines epinephrine and norepinephrine, which are hormones that regulate blood pressure and heart rate

What is rheumatoid arthritis?

Its a symmetrical systemic autoimmune disease that causes inflammation of connective tissue

Hypothyroidism

Levothyroxine Synthetic form of thyroxine (T4,T3, or both) Need to take on an empty stomach

The nurse has taught a client with newly diagnosed type 2 diabetes mellitus. Which of the following statements by the client would indicate a correct understanding of the teaching? A. My body does not properly respond to insulin B. My condition was caused by consuming foods high in sugar C. My condition can be cured with prescribed medication D. My immune system destroyed insulin-producing cells in my pancreas

My body does not properly respond to insulin (develops due to impaired tissue response to insulin and or inadequate insulin secretion from pancreatic beta cells, causing hyperglycemia)

A nurse is providing teaching to a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? A. my cells are resistant to the effects of insulin B. my body breaks down sugar to efficiently C. My pancreas does not produce insulin D. My body produces antibodies against pancreatic beta cells

My cells are resistant to the effects of insulin Type 2 diabetes mellitus will have resistance and a decrease in the secretion of insulin by the pancreatic beta cells

Intermediate insulin

NPH (HUMULIN N) Onset 1-2 hrs Peak 6-14 Duration 16-24 hrs

A school nurse is assessing a child who has been stung by a bee. The childs hand is swelling and the nurse notes that the child is allergic to insect stings. Which of the following findings should the nurse expect if the child develops anaphylaxis? A. Bradycardia B. Nausea C. Hypertension D. Urticaria E. Stridor

Nausea, urticaria, stridor other symptoms dyspnea, tachycardia, hypotension due to histamine being a potent vasodilator

Intermediate Insulin

Onset: 1-2 Peak: 4-8 Duration: 8-12

Short acting/Regular insulin

Onset: 30 min Peak: 1-3 hr Duration: 4-8

Long-acting insulin

Onset: 30-60 min Peak: NONE duration: 16-24 hr

How to treat Hypoglycemia?

Oral orange juice is the patient can swallow Glucagon Dextrose 50% IV

Type 1 diabetes treatment mechanism of action

Promotes cellular uptake of glucose Converts glucose to glycogen

Hyperglycemic hyperosmolar state

Type 2 Occurs in elderly Insidious onset days/weeks Mental. neuro, and seizures are common BG greater than 600 Fluid deficit 8-10L Bicarb therapy no needed Serum osmolality greater than 320 mOsm

Antidiuretic Hormone replacement

Vasopressin, Desmopressin Used to treat diabetes insipidus, mimics ADH promoting reabsorption of water in the kidney. Decreases urine output increases urine osmolality

A nurse is assessing a preschooler who has HIV. Which of the following manifestations should the nurse expect? A. Generalized petechiae B. Jaundice C. Obesity D. Chronic Diarrhea

chronic diarrhea

Biguanides (antidiabetic)

increases tissue sensitivity to insulin, suppresses gluconeogenesis in the liver (reduce production of glucose by liver) Increases muscle glucose uptake and intestinal glucose uptake Common drug is metform

During anaphylaxis how much epinephrine should you administer and where?

0.3-.05 mg IM preferably in the outer thigh and it can be repeated every 5-15 minutes

The nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which of the following findings would be consistent with the condition? SATA A. Decreased serum sodium level B. Decreased urine output C. Dry mucous membranes D. Low urine specific gravity E. Sudden weight gain

A. Decreased serum sodium level B. Decreased urine output E. Sudden weight gain (causes low serum osmolality and low serum sodium level AKA dilutional hyponatremia, ADH is secreted and water is retained, urine output is decreased and concentrated, resulting in a high urine specific gravity, water retention results in weight gain, hyponatremia and fluid overload results in dyspnea on exertion, headache and fatigue)

A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerace. The client has an increased thyroid-stimulating hormone TSH level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? A. Methiamazole B. Somatropin C. Levothyroxine D. Propylthiouracil

C. Levothyroxine

ADDISON disease (adrenocortical insufficiency)

Hydrocortisone -mimics naturally occurring cortisol -additional dose required in times of acute stress (surgery) -Side effects decreased immune system and increased blood sugar

A nurse is caring for a client who has diabetes insipidus. Which of the following findings should the nurse monitor? A. Proteinuria B. Oliguria C. Polyuria D. Glycosuria

Polyuria Diabetes insipidus is characterized by increased thirst (polydipsia) and increased urination (polyuria). A client who has diabetes insipidus will excrete large quantities of urine with a very low specific gravity

Thyroid cancer

Radioactive Iodine -destroys thyroid producing cells -contraindicated in pregnancy -monitor for hypothyroidism

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? SATA A. Tachycardia and hypertension B. Resp. rate 16 C. negative Chvostek sign D. Laryngeal stridor and hoarseness E. Positive Trousseaus sign

Tachycardia and hypertension Laryngeal stridor and hoarseness Positive trousseaus sign

A nurse is teaching a client who is at 12 weeks gestation and has HIV. Which of the following statements should the nurse include in the teaching? A. breastfeed your newborn to provide passive immunity B. Abstain from sexual intercourse throughout the pregnancy C, You will be in isolation after delivery D. You should continue to take zidovudine throughout the pregnancy

You should continue to take zidovudine throughout the pregnancy Taking the medication every day decreases the risk of transmitting HIV to her newborn

A community health nurse is caring for a client who was exposed to HIV 2 days ago. The client asks the nurse what she should do. Which of the following responses should the nurse provide? A. I will administer an HIV vaccine today, and it will need to be repeated in 3 months B. I will administer an HIV test today and you will need to return in 48 hours to have me read the results C. You will need to have an HIV test every other week for 6 months D. You will need to take prophylactic medications for 4 weeks

You will need to take prophylactic medications for 4 weeks

A nurse is providing teaching to a client who has Addison disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching? A. Sliced bananas B. Baked Potatoe C. Turkey and cheese sandwich D. plain yogurt with peaches

a turkey and cheese sandwich. The client who has Addison's disease requires a diet low in potassium and high in sodium, carbs, and protein.

A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following types of isolation should the nurse implement to prevent the transmission of HIV? A. Protective isolation B. Droplet precautions C. Standard precautions D. Airborne precautions

standard precautions (HIV is spread through blood and body fluids)

A nurse is providing teaching about antiretroviral medication therapy to a client who has a new diagnosis of AIDS. Which of the following statements should the nurse include in the teaching? A. Your provider will prescribe a single antiretroviral medication at a time B. You should take the antiretroviral medication on a routine schedule C. You should increase your intake of raw fruits and vegetables while taking antiretroviral medications D. Your provider will prescribe antiretroviral therapy to kill HIV

you should take antiretroviral medication on a routine schedule take exactly as prescribed and to avoid delaying or skipping any doses which can result in medication resistance

Short acting/Regular insulin

30-60 minutes before meals to control postprandial hyperglycemia U-500 is for insulin resistance U-100 is for most clients and can be given IV

How often should you get tested for exposure to HIV? A. every week B. As soon as possible C. annually D. 4-6 weeks, 3 months and 6 months

4-6 weeks, 3 months, 6 months

During anaphylaxis you need to give the client oxygen how much do you give?

8-10 L/min via face mask you can give up to 100% as needed

The nurse is caring for a client with Syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse include in the plan of care? SATA A. Implement seizure precautions B. Monitor daily weights C. Monitor serum osmolality D. Perform frequent neurological checks E. Place the client on fluid restriction

A. Implement seizure precautions B. Monitor daily weights C. Monitor serum osmolality D. Perform frequent neurological checks E. Place the client on fluid restriction All are correct for SIADH

A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following laboratory values is consistent with DKA? A. Blood glucose 30 mg/dl B. negative urine ketones C. Blood pH 7.38 D. Bicarbonate level 12

Bicarbonate level 12 The client who has DKA should have a bicarbonate level less than 15 mEq/L because the client has an increased production of counter regulatory hormones that lead to metabolic acidosis.

A nurse is reviewing the laboratory reports of a client and notes an elevated thyroid-stimulating hormone level. Which of the following findings should the nurse expect? A. Bradycardia B. Tremors C. Low-grade fever D. Diaphoresis

Bradycardia an elevated TSH level indicates hypothyroidism which is characterized by weight gain, bradycardia, cold intolerance, paresthesia, hearing loss, depression

During anaphylaxis you need to give the client a corticosteroid IV, what is the name of the medication?

Methylprednisone

What is regular insulin mechanism of action?

Moves potassium (K) into cells as treatment for hyperkalemia-IV only

Diabetic Ketoacidosis

Present in TYPE 1 Ketosis/acidosis: present any age Onset is rapid 1-2 days N&V, abdominal pain mental change is less common BG greater than 250 Fluid deficit 3-5 L Bicarbonate therapy: needed Mortality 2-5% Metabolic acidosis: present

During anaphylaxis what happens to the blood pressure?

The blood pressure drops and is low

A nurse is preparing to change the bed linens of a client who has AIDS and is incontinent of stool. Which of the following personal protective equipment items should the nurse don prior to providing client care? A. Gown B. Gloves C. Mask D. Hair cover E. Goggles

gown and gloves

A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestions of hyperglycemia. Which of the following findings should indicate to th enurse that the client has hyperglycemia? A. hunger B. Increased urination C. Cold, clammy skin D. Tremors

increased urination Increased urination or polyuria is a manifestation of hyperglycemia due to a deficiency of insulin which can lead to osmotic diuresis.

Rapid acting insulin

onset: 5-15 minutes Peak: 30-60 min Duration:2-5 hr

A nurse is assessing a client who has Addisons disease. Which of the following skin manifestations should the nurse expect to find? A. Purple striae on the chest and abdomen B. Butterfly rash across the bridge of the nose C. Bronze pigmentation of skin D. Jaundice of the face and sclera

Bronze pigmentation of skin The client who has Addison's disease will have a darkening of the skin in both exposed and unexposed parts of the body due to a hormone deficiency caused by damage to the outer layer of the adrenal gland

A nurse is caring for a client who has diabetes insipidus. Which of the following laboratory values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder? A. Sodium 152 B. Potassium 6.0 C. Creatinine clearance 50 D. Aspartate aminotransferase 52 units

Creatinine clearance 50 ml clearance should be above 87 for female and 107 male. Clearance of 50 indicates renal impairment and is a contraindication to receiving vasopressin. Renal impairment increases the likely hood of the life-threatening adverse effect of water intoxication

A nurse is teaching a client who is taking levothyroxine for hypothyroidism about a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching? A. The calcium supplement will enhance the effect of the levothyroxine B. the calcium supplement will accelerate the metabolism of the levothyroxine C. Take the medications together at 1700 for the greatest effect D. Take the calcium supplement 4 hr after taking the levothyroxine

D. Take the calcium supplement 4 hr after taking the levothyroxine (levothyroxine should be taken in the morning on an empty stomach, and the calcium supplement should be taken at least 4 hours later.

A nurse is teaching the guardian of a school age child who has diabetes mellitus how to recognize diabetic ketoacidosis. Which of the following findings should the nurse identify as a manifestation of this complication? A. slow heart rate B. Protruding eyeballs C. Deep and rapid respirations D. Decreased urinary output

Deep and rapid respirations

A nurse is reviewing the medical record of a client who is receiving hydrochlorothiazide. The nurse should expect to find an improvement in which of the following conditions as a result of this medication? A. Gouty Arthritis B. Dehydration C. Diabetes insipidus D. Hypokalemia

Diabetes insipidus Thiazides reduce urine production by 30% to 50%

The nurse is assessing a client with hyperthyroidism. Which of the following findings would be consistent with the condition? A. fine tremor B. Weight gain C. Bradycardia D. long menstrual periods

Fine tremor Manifestations of hyperthyroidism occur in relation to increased metabolism and oxygen consumption and include fine tremor

A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? A. Glycosylated hemoglobin levels B. Urine sugar and acetone C. Glucose tolerance test D. Fasting serum glucose

Glycosylated hemoglobin levels HbA1c

A nurse is teaching a client who has HIV about how the virus is transmitted. Which of the following statements should the nurse include in the teaching? A. HIV can be transmitted as soon as a person develops manifestations B. HIV can be transmitted to anyone who has had contact with infected blood C. HIV is transmitted through the respiratory route via droplets D. HIV is transmitted only during the active phase of the virus

HIV can be transmitted to anyone who has had contact with infected blood (the concentration of the virus is highest in the blood but also has been isolated in other body fluids including sputum, saliva, cerebrospinal fluid, urine, and semen. Clients who have HIV are cautioned to practice safe sex avoid donating blood and abstain from sharing needles with others)

A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing ad adverse effect of this medication? A. Thirst B. Nocturia C. Headache D. Heart palpitations

Headache Headaches are an indicator of the adverse effect of water intoxication which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication

A nurse is caring for a client who has been diagnosed with an Addisonian crisis and has a blood pressure of 74/42. Which of the following prescriptions should the nurse anticipate? A. Desmopressin B. Hydrocortisone C. Dopamine D. Furosemide

Hydrocortisone The nurse should identify that a client who has Addison's disease is experiencing an Addisonian crisis will require hydrocortisones to assist with replacing cortisone levels. A client who has Addison's disease has adrenal corticoid insufficiency which is due to the pituitary's inability to produce cortisol. Illness and stress can require steroids like hydrocortisone to restore hormone levels. An Addisonian crisis can cause sudden destruction of the adrenal gland or pituitary and become life threatening.

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following should the nurse expect? A. Polyuria B. Dehydration C. Hyponatremia D. hyperthermia

Hyponatremia The client who has SIADH will have hyponatremia caused by the excessive release of an antidiuretic hormone (ADH). As a result of the excess ADH, the client retains water that causes dilutional hyponatremia

A nurse is providing discharge teaching to the partner of a client who has AIDS. Which of the following statements by the clients partner indicates a need for further teaching? A. I will dispose of soiled tissues in separate plastic bags B. I'll clean up blood spills immediately with hot water C. I know that handwashing is an important preventative measure D. I will was soiled clothes in hot water

Ill clean up blood spills immediately with hot water (the clients partner should clean blood or potentially contaminated body substances with a bleach solution and wear gloves when coming into contact with blood products)

What does an HgA1c greater than 5.7% mean?

Impaired fasting glucose or impaired glucose tolerance

Long insulin

Insulin glargine (Lantus) Onset 70 minutes Peak None Duration 24 hrs

A nurse is caring for a client who has Diabetic Ketoacidosis. Which of the following findings should the nurse expect? A. Urine negative for ketones B. Distended neck veins C. Kussmaul respirations D. Elevated blood pressure

Kussmaul respirations (these deep and rapid respirations are the bodys attempt to exhale carbon dioxide to reverse the metabolic acidosis that occurs with DKA)

Rapid insulin

Lispro (humalog) onset is 15-30 mins Peak 30 to 2.5 hrs Duration 3-6 hours

A nurse is teaching a client who has AIDS about the transmission of pneumocystis Jiroveci pneumonia (PCP). Which of the following pieces of information should the nurse include in the teaching? A. PCP is sexually transmitted from person to person B. You were most likely exposed to a contaminated surface such as a drinking glass C. PCP results from an impaired immune system D. You might have contracted PCP from a family pet

PCP results from an impaired immune system the organism that causes PCP exists as part of the normal flora of the lungs and develops into a fungus. It becomes an aggressive pathogen when the immune system is compromised, causing infection

Gliptins DPP-4 Inhibitors (antidiabetic)

Promotes incretin secretion to increase insulin secretion and decrease glucagon secretion Sitagliptin

Hyperthyroidism

Propylthiouracil Blocks synthesis of thyroid hormones -take with meals -Watch for hypothyroidism Watch for leukopenia and thrombocytopenia

During anaphylaxis you give the client nebulized albuterol to treat bronchospasm that is resistant to epinephrine what is the name of the albuterol?

Proventil

Signs of hypoglycemia

Shaky, sweaty, palpitations, nervous, tingling around lips and tongue, hungry, weakness, vision changes, irritability, difficulty speaking, headaches, personality changes, coma, seizures.

Growth Hormone Replacement

Somatropin Growth hormone deficiencies (Turner's, Prader-Wili) Used to stimulate growth and protein production

A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the following interventions should the nurse include in the plan of care? A. rinse the mouth with chlorhexidine solution every 2 hrs B. Limit fluid intake with meals C. Provide oral hygiene with a firm-bristled toothbrush after each meal D. Avoid salty food

Stomatitis is an inflammation of the mucosa of the mouth usually with ulcerations. Foods that are spicy acidic or salty should be avoided to prevent further irritation and damage to the oral mucosa

Thyrotoxic crisis/storm pre-thyroidectomy

Strong iodine solution inhibits thyroid production and hormones release due to high levels of iodine Contraindicated in pregnancy use a straw to avoid teeth stain short term use only 10 s/p surgery

A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. The nurse should identify which of the following laboratory results as supporting the administration of this medication? A. TSH 8 microunits/mL B. Free triiodothyronine (T3) 300 pg/dL C. Free Thyroxine (T4) 7 mcg D. Thyroxine binding globuline 2.3 mg/dL

TSH 8 microunits Normal TSH 0.3-5

Side effects of metformin (antidiabetic)

Take with food may cause gas, anorexia, nausea and vomiting watch for myalgia, sluggishness, somnolence, hyperventilation, SOB, tachycardia, N/V no alcohol If need an iodinated contrast dye procedure stop medication 24-48 hours

A nurse is caring for a client who is postoperative following a parathyroidectomy. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure? A. Calcium B. Sodium C. Potassium D. Phosphorus

The parathyroid hormone regulates calcium, phosphorus and magnesium, balance within the clients blood and bone by maintaining balance between the mineral levels in the blood and the bone. Hyperparathyroidism is associated with hypercalcemia; there for a decrease in the calcium level indicates an improvement in the clients condition

A nurse is planning care for a client who has syndrome of inappropriate antidiuretic hormone secretion with mild manifestations. The nurse should expect the provider to prescribe which of the following medications? A. Chlorpropamide B. Tolvaptan C. Vasopressin D. Desmopressin

Tolvaptan SIADH is a disorder of water intoxication due to the inappropriate continuous secretion of antidiuretic hormone by the posterior pituitary gland causing hypervolemia and hyponatremia. Treatment of SIADH includes fluid restriction, sodium replacement with small amounts of 0.9 sodium chloride and a vasopressin antagonist such as tolvaptan. Tolvaptan promotes the excretion of water which helps correct the fluid imbalance in clients who have SIADH

Sulfonylureas (antidiabetic)

Used in conjunction with diet and exercise in the treatment of type 2 diabetes mellitus. It stimulates pancreas beta cells to secrete insulin Common meds are Glipizide and Glyburide Monitor for hypoglycemia and avoid alcohol due to disulfiram effect

A nurse is preparing a 24 hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24 hour specimen should the nurse use to determine the clients condition? A. Creatinine clearance B. Vanillylmandelic acid(VMA) C. 17-hydroxycorticosertorids D. Protein

Vanillylmandelic acid (VMA) This test is used to determine pheochromocytoma which meausres the level of catcholamine metabolites in a 24 hr urine sample

What is high specific gravity means in urine?

Very concentrated urine due to dehyrdration, diarrhea, emesis, head trauma, excessive sweating, UTI, decreased blood flow to kidney

A nurse is providing discharge teaching to a client who has AIDS about preventing infection while at home. Which of the following instructions should the nurse include in the teaching? A. Wash your genitalia using an antimicrobial soap B. Rinse your dishes with cold water C. Clean your toothbrush once per month D. Incorporate raw fruits and vegetables into your diet

Wash your genitalia using antimicrobial soap (toothbrush should be cleaned once per week by running it through the dishwasher or rinsing it with bleach)

A nurse is providing dietary teaching for a client with aids who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching? A. You can suck on popsicles to numb your mouth B. Season food with spices instead of salt C. Avoid the use of a straw to drink liquids D. Eat foods at hot temperatures

You can suck on popsicles to numb your mouth

A nurse is monitoring a client who has graves disease for the development of thyroid storm. The nurse should report which of the following findings to the provider? A. Constipation B. Headache C. Bradycardia D. Hypertension

hypertension The client who is experiencing a thyroid storm will have an exaggerated condition of hyperthyroidism associated with the development of fever, hypertension, abdominal pain and tachycardia. Graves disease is a common cause of hyperthyroidism which is an imbalance of metabolism caused by overproduction of the thyroid hormone

A nurse is conducting dietary teaching for a client who has AIDS. Which of the following instructions should the nurse include in the teaching? A. Discard leftovers after 8 hrs B. Use a separate cutting board for poultry C. Thaw frozen foods at room temperature D. Store cold foods at 10 C (50 F) or less

use a separate cutting board for poultry the nurse should instruct the client to use a separate cutting board for raw poultry. Raw poultry can contain bacteria such as salmonella, which may contaminate other foods or work surfaces. Using a separate cutting board prevents cross-contamination of work surfaces when preparing food