Endocrine Problems 2
After hypophysectomy, a client complains of being thirsty and having to urinate frequently. What is the initial nursing action?
Assess urine specific gravity.
A client with diabetes mellitus has a blood glucose level of 644 mg/dL (35.7 mmol/L). The nurse plans care, knowing that the client is at risk for the development of which type of acid-base imbalance?
Metabolic acidosis
A client with diabetes mellitus is most likely to experience which type of acid-base imbalance as a complication of the disorder?
Metabolic acidosis
The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul's respirations. The nurse plans care, understanding that the purpose of this type of breathing is to correct what imbalance?
Metabolic acidosis
A nurse is assisting a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) to develop a plan to prevent a recurrence. Which is most important to include in the plan of care?
Monitor blood glucose levels frequently.
A client with type 1 diabetes mellitus in the emergency department is diagnosed with diabetic ketoacidosis (DKA). Which interventions would the nurse anticipate being prescribed initially? Select all that apply.
Monitoring urine for ketones Intravenous potassium replacement Administration of intravenous insulin
The nurse collects a 24-hour urine specimen for catecholamine testing from a client with suspected pheochromocytoma. The results of the catecholamine test are reported as epinephrine 20 mcg (109 nmol) and norepinephrine 100 mcg (590 nmol). The nurse would make which interpretation about this result?
Normal results for a client with pheochromocytoma
A client with Graves' disease has exophthalmos and is experiencing photophobia. Which nursing action would best assist the client with these manifestations?
Obtain dark glasses for the client.
A client with diabetes mellitus has been instructed in the dietary exchange system. The client asks the nurse if bacon is allowed in the diet. Which nursing response is most appropriate?
One strip of bacon may be eaten if you eliminate 1 teaspoon of butter."
A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which concept?
Systematically rotate insulin injections within one anatomical site
The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse would ensure that which piece of medical equipment is at the client's bedside?
Tracheotomy set
Endocrine Problems 2
Truncal obesity
A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse would assess for the major sign associated with pheochromocytoma by performing which action?
aking the client's blood pressure
A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot care. Which instruction would be included in the plan?
apply a moisturizing lotion to dry the feet but not between the toes.
A client has received an unsealed radioactive isotope for treatment of thyroid cancer. Which instruction is essential for the nurse to provide the client?
flush the toilet at least 3x after use.
The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diet. Which statement, if made by the client, indicates a need for further teaching?
"I need to drink diet soft drinks.
The family of a bedridden client with type 2 diabetes mellitus and chronic kidney disease calls the nurse to report symptoms of headache, polydipsia, and increased lethargy. Which most important question would the nurse ask the family to determine a possible problem?
"What is the client's capillary blood glucose level?
The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how would the nurse inform the client?
"You need to increase salt in your diet, particularly during stressful situations."
A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis and a serum glucose level of 789 mg/dL (45 mmol/L). The primary health care provider (PHCP) prescribes 10 units of regular insulin by intravenous (IV) bolus, followed by a continuous insulin infusion at a rate of 5 units/hr. The pharmacy sends 500 mL of normal saline solution containing 50 units of regular insulin. After administering the IV bolus of 10 units of regular insulin, the nurse sets the infusion pump flow rate of the normal saline solution containing 50 units of regular insulin to infuse at how many milliliters per hour to deliver 5 units/hr? Fill in the blank.
10 ml/hr
The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the client's fasting serum glucose level is normal if which value is noted?
120 mg/dL (6.9 mmol/L)
The nurse is caring for a client who had intracranial surgery and is now suspected of having developed diabetes insipidus (DI). What initial prescription would the nurse expect from the primary health care provider (PHCP)?
24-hour fluid intake and output without restricting food or fluid intake
A client with diabetes mellitus reports to the clinic for determination of the glycosylated hemoglobin (HbA1c) level. Which value on this laboratory test indicates client compliance with the prescribed diabetic regimen?
6%
The nurse is reviewing the laboratory test results for a client and notes that the serum potassium level is 5.5 mEq/L (5.5 mmol/L). The nurse understands that this value would be noted in which condition?
Addison's disease
A 33-year-old client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment?
Amenorrhea
The nurse is assessing a client who has a diagnosis of goiter. Which would the nurse expect to note during the assessment of the client?
An enlarged thyroid gland
The nurse is taking a health history for a client with hyperparathyroidism. Which question would elicit information about this client's condition?
Are you experiencing pain in your joints?"
A client received 5 units of insulin aspart subcutaneously just before eating lunch at 12:00 p.m. The nurse would assess the client for a hypoglycemic reaction at which times?
Between 1:00 and 3:00 p.m.
A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse would next assess the results of which serum laboratory study?
Calcium
The nurse is preparing to care for a client recovering from a subtotal thyroidectomy. Which supplies would the nurse have readily accessible for the care of this client? Select all that apply.
Calcium gluconate Prefilled syringe of 50% glucose Tracheostomy tube insertion set
A client visits the primary health care provider's office for a routine physical examination and reports a new onset of intolerance to cold. Since hypothyroidism is suspected, which additional information would be noted during the client's assessment?
Complaints of weakness and lethargy
The nurse is caring for a client with diabetic ketoacidosis whose respirations are abnormally deep, regular, and increased in rate. The nurse monitors the client, expecting that which occurs with this type of respiration? Select all that apply.
Correction of bradypnea Correction of metabolic acidosis Correction of an acid-base imbalance
A nurse needs to maintain food and fluid intake to minimize the risk of dehydration in a client with diabetes mellitus who has gastroenteritis. Which is the appropriate nursing intervention?
Encourage the client to take 8 to 12 oz of fluid every hour while awake.
A client with type 1 diabetes mellitus tells the nurse they might lose their job because of having frequent hypoglycemic reactions. Their boss thinks that the client is drunk during these episodes and that they have been drinking on the job. Which action by the nurse would best assist this client to meet the client's needs?
Examine factors with the client that may be causing frequent hypoglycemic episodes.
A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which items would be the most appropriate choice for this client to meet nutritional needs?
Graham crackers and warm milk
A client with type 2 diabetes mellitus is complaining of polydipsia, polyuria, weight loss, and weakness. Laboratory results indicate a blood glucose level of 800 mg/dL (45.7 mmol/L) and nonketosis. The nurse reviews the primary health care provider's documentation and expects to note which diagnosis?
Hyperosmolar hyperglycemic syndrome (HHS)
The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction?
I need to avoid foods high in potassium."
The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which client statement indicates an understanding of the nurse's instructions? *
I will definitely have to continue taking antithyroid medications after this surgery."
A nurse has provided dietary instructions to a client with Addison's disease. Which statement made by the client indicates that the client understands the instructions?
I will maintain a normal sodium intake in my diet."
The nurse is caring for a client who had a transsphenoidal hypophysectomy. Which statements would the nurse include in the discharge teaching instructions? Select all that apply.
Include adequate fiber and fluids in your diet." Wear slip-on shoes rather than those that need to be tied." Brushing your teeth will not be permitted for at least 2 weeks after surgery." "Contact your primary health care provider immediately if you develop any headache, fever, or neck stiffness."
The nurse is preparing to care for a client after parathyroidectomy. The nurse would plan for which action for this client?
Place the client in a flat position with the head and neck immobilized.
A primary health care provider has prescribed methimazole for a client with hyperthyroidism. The nurse would question the client about which of the following that is a contraindication to the use of this treatment?
Pregnancy
A nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. The nurse would ask the client if which measure is taken?
Rotating sites for injection
The nurse is caring for a postoperative client who has had an adrenalectomy. What would the nurse check for during the client's focused assessment?
Signs and symptoms of hypovolemia
The nurse is assessing the learning readiness of a client newly diagnosed with diabetes mellitus. Which behavior indicates to the nurse that the client is not ready to learn?
The client complains of fatigue whenever the nurse plans a teaching session.
A client is experiencing the syndrome of inappropriate antidiuretic hormone (ADH) secretion. When explaining this disorder to the client and family, the nurse recalls that ADH works to reabsorb water in which parts of the nephron?
The distal tubule and the collecting duct
A nurse is caring for a client after a thyroidectomy. Which specific emergency equipment would the nurse have available as it relates to this procedure?
Tracheostomy tray
A multidisciplinary health care team is developing a plan of care for a client with hyperparathyroidism. The nurse would include which priority intervention in the plan of care? *
Walk down the hall for 15 minutes 3 times a day.
A client with diabetes mellitus is scheduled for a fasting blood glucose level determination in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information about fluid and food intake, the nurse clarifies by stating that which would be acceptable to consume before the test?
Water
A client with type 2 diabetes mellitus presents to the primary health care provider's office with a glycosylated hemoglobin (HgbA1C) level of 10.5%. Which statement by the client indicates an understanding of this test and its results?
Well, I have 3 months to really work on watching my diet and lowering my blood sugar. My next glycosylated hemoglobin test will be better then."
The client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which statement is the appropriate response by the nurse?
You have concerns about the surgical treatment for your condition?
