Endocrine Questions

What are priority assessments for a patient status post-op thyroidectomy? Management of each?

- Airway - Hypocalcemia

A patient with high T3 and T4 levels, will likely have which of the following symptoms? SATA a. Diarrhea b. Tachycardia c. Low energy d. Weight loss e. Hair loss f. Insomnia

A, B, D, E, F

A person with hypothyroidism is treated with levothyroxine (Synthroid). If the patient is not receiving enough medication, which of the following symptoms would you expect? (SATA) a. Constipation b. Diarrhea c. Bradycardia d. Tachycardia e. Perspiration f. Dry skin g. Weight gain h. Weight loss

A, C, F, G

Tx or Hyperparathyroidism

Calcitonin salmon

Tx for SIADH

Demeclocycline (Declomycin)

Tx for Diabetes Insipidus

Desmopressin (DDAVP)

True of false: Hyperthyroidism is most often found in females, sedentary lifestyle nearing menopause.

False: Hyperthyroidism is most common in women, ages 20-40

True of false: Patients with a history of coronary heart disease who start taking medication for the treatment of hypothyroidism are at a greater risk for having angina and possible an MI

False: levothyroxine may lead to an increase in oxygen demand of the heart

Tx for Addison's Disease

Hydrocortisone

Tx for Cushings syndrome

Ketoconazole (Nizoral)

Tx for Hypothyroidism

Levothyroxine

Tx for Hyperthyroidism

Propylthiouracil (PTU)

Tx for Growth Hormone Deficit

Somatropin (Humatrope)

True of false: Syndrome of Inappropriate ADH (SIADH) will result in increase intravascular volumes, dilutional hyponatremia, weight gain, low urine output and may develop seizures from low serum sodium levels

True

Some endocrine diseases, such as Addison's, Cushing's Syndrome, DI, and SIADH, result in fluid volume disturbances. Independent nursing interventions may include all of the following except: a. Basic lab panel ordered b. Assessment for edema c. Daily weights d. Patient education about fluid retention

a. Basic lab panel ordered: not independent nursing

Which of the following assessments would indicate the client was experiencing a thyroid storm? a. HR 140, temp 39 C, agitation b. HR 75, temp below 36.2 C, angry c. HR 132, temp 37.5 C, confusion d. HR 160, temp 36 C, lethargy

a. HR 140, temp 39 C, agitation

Which medication is used to block thyroid hormone and therefore used in Thyrotoxicosis/Thyroid storm? a. Propylthiouracil (PTU) b. Propranolol (Inderol) c. Pancrelipase (Creon) d. Promethazine (Phenergan)

a. Propylthiouracil (PTU): used to treat Grave's disease

Ms. H is a 47-year-old mother of three who had cranial surgery to remove a pituitary tumor 3 days ago, leaving her with partial left hemiparesis and diabetes insipidus. Which of the following nursing diagnoses is of the greatest priority postoperatively? a. fluid volume deficit, risk for, related to excessive loss via the urinary system b. hopelessness, related to development of chronic illness (hemiparesis and diabetes insipidus c. Oral mucosa membrane alteration, risk for, related to dehydration d. Coping, ineffective family: compromised, risk for, related to chronic illness

a. fluid volume deficit, risk for, related to excessive loss via the urinary system

A client with intractable asthma develops Cushing syndrome. Development of this complication can most likely be attributed to long-term or excessive use of: a. prednisone b. theophylline c. metaproterenol (Alupent) d. Cromolyn (Intal)

a. prednisone

A client with COPD presents to the emergency room with muscle weakness, hypotension, hypoglycemia, and fatigue. The client's family reports that the client recently stopped taking all medications because the medications were too expensive. The nurse reviews the list of medications provided by the family and notes that the client has been taking prednisone daily. Based upon this information, the nurse's assessment findings are consistent with characteristics associated with: a. Cushings syndrome b. Addisons disease c. Pheochromocytoma d. Thyrotonixcosis

b. Addisons disease

A patient with Addison's Disease has been treated with hydrocortisone. The health care provider determines that the patient is not receiving adequate "mineralcorticoid" action from the hydrocortisone. Which one of the following medications is a "mineralcorticoid" agent that can be given to this patient? a. Ketaconazole (Nizoral) b. Fludrocortisone (Florinef) c. Prednisolone (Prednisone) d. Dexamethasone (Decadron)

b. Fludrocortisone (Florinef): maintains normal sodium levels and help with water retention

Which statement would not be offered to a patient receiving discharge education for Levothyroxine (Synthroid)? SATA a. Take this med first thing in the morning on an empty stomach b. Take this med at the same time every night as it impact your circadian rhythm c. If you miss a dose, take this med as soon as you realize the dose was missed, or it within hours to the next dose - wait for the next dose time d. Continue this medication for the rest of your life, as prescribed by your provider e. Your dose may be increase based upon annual lab values taken from blood draws

b. Take this med at the same time every night as it impacts your circadian rhythm

The client has returned from surgery following a total parathyroidectomy. The nurse should assess for which of the complications following this surgery? a. tetany b. hypocalcemia c. brittle bones d. fatigue

b. hypocalcemia

Vasopressin is administered to the client with diabetes insipidus (DI) because it: a. decrease blood pressure b. increases tubular reabsorption of water c. increases release of insulin from the pancreas d. decreases glucose production within the liver

b. increases tubular reabsorption of water

Bone resorption is a possible complication of cushing disease. Which of the following interventions should the nurse recommend to help the client prevent this complication? a. increase the amount of potassium in the diet b. maintain a regular program of weight-bearing exercise c. limit dietary vitamin D intake d. perform isometric exercises

b. maintain a regular program of weight-bearing exercise

Which of the following symptoms might indicate that a client has developing tetany after a subtotal thyroidectomy? a. Pains in the joints of the hands and feet b. Tingling in the fingers c. Bleeding on the back of the dressing d. Tension on the suture line

b. tingling in the fingers

Which of the following is NOT a clinical manifestation of Cushing Syndrome? a. Ecchymosis b. weak radial pulses c. slow wound healing d. moon face and buffalo hump

b. weak radial pulses

A 60-year-old woman is diagnosed with hypothyroidism. Signs and symptoms of hypothyroidism include? a. Tachycardia b. Weight gain c. Diarrhea d. Nausea

b. weight gain

A client with thyrotoxicosis says to the nurse, "I am so irritable, I am having problems at work because I lose my temper very easily." Which of the following responses by the nurse would give the client the most accurate explanation of her behavior? a. Your behavior is caused by temporary confusion brought on by your illness b. Your behavior is caused by the excess thyroid hormone in your system c. Your behavior is caused by your worrying about the seriousness or your illness d. Your behavior is caused by the stress of trying to manage a career and with with illness

b. your behavior is caused by the excess thyroid hormone in your system

Replacement corticosteroid therapy is prescribed for: a. SIADH b. Thyroid storm c. Addison's disease d. Diabetes insipidus

c. Addison's disease: hypofunction of the adrenal cortex resulting in low level of hormones

Which lab would you expect in a patient with diabetes insipidus? a. K+ = 4.2 b. Na+ = 128 c. Hct = 51 d. FSBS = 104

c. Hct: DI causes dehydration and therefore a high HCT, related to intravascular depletion is expected

The hormones responsible for "fight or flight" are: a. estrogen and testosterone b. FSH and LH c. Epinephrine and norepinephrine d. Calcitonin and parathormone

c. epinephrine and norepinephrine

The client has returned following a thyroidectomy. How should the client be positioned to promote comfort? a. side lying (lateral) with one pillow placed under the head b. head of the bed elevated 30 degrees and no pillows placed under the head c. semi-fowlers with the head supported on two pillows d. flat, with small roll supporting neck

c. semi-fowlers with the head supported on two pillows

Which of the following nursing interventions is MOST important for care of a patient with Diabetes Insipidus? a. Strict fluid restrictions b. Auscultation of lungs for crackles c. Monitor airways for stridor and increased work fo breathing d. Patient education for ADH replacement therapy

d. Patient education for ADH replacement therapy: replacement of DDVAP or Vasopressin

A 78-year-old male client has been newly diagnosed with hypothyroidism. He lives in his own apartment in a community development designed for the elderly. He asks the nurse assigned to this complex for advice about his condition. What would be the best advice the nurse could give the client? a. stop taking your self-prescribed daily aspirin b. stop attending group activities c. keep the temperature in your apartment cooler than usual d. increase fiber and fluids in your diet

d. increase fiber and fluids in your diet

The nursing care for the client in Addison's crisis should include which of the following intervention? a. encouraging independence with activities of daily living (ADLs) b. allowing ambulation as tolerated c. offering extra blankets and raising the heat in the room to keep the client warm d. placing the client in a private room

d. placing the client in a private room

Which statement should the nurse make when teaching the client about taking oral glucocorticoids: a. take your medication with vitamin supplement b. take your medication on an empty stomach c. take you medication at bedtime to increase absorption d. take your medication with meals

d. take your medication with meals