Chapter 49: Introduction to the Endocrine System
During an assessment of a client's functional health pattern, which question by the nurse directly addresses the client's thyroid function?
"Do you experience fatigue even if you have slept a long time?"
Which of the following can be performed to determine a client's general status and rule out disorders?
A complete blood count and chemistry profile
A client with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a client with this condition is what?
Excess fluid volume
A client with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the client should prioritize what question when addressing potential complications?
"Do you feel any muscle twitches or spasms?"
The nurse is assessing mental and emotional status in a client about to begin therapy for an endocrine disorder. Which of the following would the nurse test to assess the client's mental and emotional status?
Ability to respond to questions
A nurse is caring for clients in the emergency department and feels very stressed. What endocrine structure is releasing stress hormones to contribute to the nurse's response?
Adrenal medulla
Which of the following hormones controls secretion of adrenal androgens?
Adrenocorticotropic hormone (ACTH)
The nurse is caring for a client with hyperparathyroidism. What level of activity would the nurse expect to promote?
Ambulation and activity as tolerated
A client with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?
Blood glucose
The nurse is assessing a client diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?
Bulging eyes
The thyroid gland produces and secretes which of the following in direct response to serum calcium levels?
Calcitonin
When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted:
Calcitonin
Which hormone would the nurse identify as important in decreasing serum calcium levels?
Calcitonin
Which diagnostic test is done to determine a suspected pituitary tumor?
Computed tomography
The primary function of the thyroid gland includes which of the following?
Control of cellular metabolic activity
Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?
Cushing syndrome
A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client?
Decreased blood pressure
While palpating the neck of a client diagnosed with a thyroid disorder, the nurse takes special care to be very gentle. What is the rationale for the nurse's action?
Deep palpation of the thyroid can result in excessive release of thyroid hormone.
A 30 year-old female client has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the client's care?
Disturbed body image related to changes in physical appearance
A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate?
Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.
Following an addisonian crisis, a client's adrenal function has been gradually regained. The nurse should ensure that the client knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?
Episodes of high psychosocial stress
A patient is noted to be anemic. Which hormone will affect the development of red blood cells in this patient?
Erythropoietin
The nurse providing care for a client with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?
Establish falls-prevention measures.
What skin findings should a nurse pay particular attention to in a client with a history of endocrine problems?
Excessive hair growth or loss
The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto thyroiditis. When assessing this client, what sign or symptom would the nurse expect?
Fatigue
A patient comes to the clinic with complaints of severe thirst. The patient has been drinking up to 10 L of cold water a day, and the patient's urine looks like water. What diagnostic test does the nurse anticipate the physician will order for diagnosis?
Fluid deprivation test
A client with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the client to improve the patient's nutritional intake. What foods should a client with Cushing syndrome eat to optimize health? Select all that apply.
Foods high in vitamin D Foods high in protein Foods high in calcium
The student nurse is labeling a diagram of the endocrine system. What organ would the student nurse not include in the diagram because it is not a major organ of the endocrine system?
Gallbladder
A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?
Highly dilute urine
While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the client's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?
Hypertension and heart rate changes
A client has returned to the floor after having a thyroidectomy for thyroid cancer. What laboratory finding may be an early indication of parathyroid gland injury or removal?
Hypocalcemia
The pharmacology instructor is diagramming the nervous and endocrine systems. What organ would the instructor diagram as the connector between the nervous and endocrine systems?
Hypothalamus
The physiology instructor is talking with the class of nursing students. What would the instructor explain to the students is the connecting link between the nervous system and the endocrine system?
Hypothalamus
The nurse is caring for a client with a diagnosis of Addison disease. What sign or symptom is most closely associated with this health problem?
Muscle weakness
The hypothalamus fine tunes and regulates the release of hormones through what?
Negative feedback systems
The pharmacology instructor is discussing the endocrine system with a class of pre-nursing students. What would the instructor tell the students is considered to be a hormone?
Norepinephrine
Which glands regulate calcium and phosphorous metabolism?
Parathyroid
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 gland was originally identified as the master gland?
Pituitary
Which of the following glands is considered the master gland?
Pituitary
A client with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the client. Which is an appropriate nursing diagnosis?
Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns
A client has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the client knows to do what action?
Slowly taper down the dose of prednisone, as prescribed.
The nurse is planning the care of a client with hyperthyroidism. What should the nurse specify in the client's meal plan?
Small, frequent meals, high in protein and calories
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.
A teenage male client has not developed facial hair, a deeper voice, or other secondary sex characteristics. What hormone would the nurse expect would be checked for this client?
Testosterone
A client is prescribed corticosteroid therapy. What would be priority information for the nurse to give the client who is prescribed long-term corticosteroid therapy?
The client is at an increased risk for developing infection.
A client with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in the client's cortisol levels. How should the nurse interpret this finding?
The client's pituitary function is compromised.
The nurse is caring for a client with Addison disease who is scheduled for discharge. When teaching the client about hormone replacement therapy, the nurse should address what topic?
The need for lifelong steroid replacement
Hormones are chemicals produced in the body to perform specific functions. What is a characteristic of a hormone?
They travel through the blood to specific receptor sites throughout the body
A group of nursing students are doing a presentation on hormones. What hormone would the presentation show regulates the metabolic rate and influences the growth and development of the body?
Thyroid hormone
A client is having problems with parathyroid hormone. What vitamin would the nurse suspect as potentially contributing to the client's problem?
Vitamin D
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
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested?
adrenal function
A nurse working in the ED at a level 1 trauma center is notified that casualties from a multivehicle car accident are currently in transit. The nurse's heart is pounding and mouth is dry. What gland is responsible for this nurse's physiologic response?
adrenal medulla
Which diagnostic test is done to determine suspected pituitary tumor?
computed tomography scan
While preparing a client with mild cognitive impairment for upcoming diagnostics, the nurse includes the client's family during the information-gathering portion of the assessment. The nurse takes this action in order to:
confirm the medications the client is using.
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 nurse explains the role of the ovaries. Which hormones would be included in that discussion?
estrogen and progesterone
The nurse is educating a couple who has had difficulty with conception. The client asks about the hormone, which is responsible for the production of eggs. The nurse answers that this hormone is called:
follicle-stimulating hormone (FSH)
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
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone?
increase serum calcium level
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
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 client reports difficulty falling asleep on a nightly basis. The physician suspects a lack of melatonin. What endocrine gland secretes melatonin?
pineal gland
A client seeks treatment for disturbed sleep cycles and depressed mood. Which gland and hormone are involved in regulating sleep cycles and mood?
pineal gland; melatonin
A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume?
renin
