Endocrine Quiz
A nurse is checking labs to determine is a diabetic patient is adhering to the treatment plan. Which test should the nurse use to make this determination?
A1c
Skin manifestations of Addison's Disease
Bronze skin pigmentation, 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 (adrenal cortex).
A nurse is caring for a client who is postoperative following parathyroidectomy to treat hyperparathyroidism. What lab values should decrease as an effect of the procedure?
Calcium Hyperparathyroidism is associated with hypercalcemia, hypophosphatemia
Type 2 diabetes pathophysiology
Cells are resistant to the effects of insulin
A nurse is assessing a client who has Grave's disease. What findings should the nurse expect the client to display due to the overproduction of thyroid hormone?
Difficulty sleeping and anxiety Heat intolerance Weight loss and increased appetite Diarrhea
Exercise and Type 1 Diabetes
Exercise potentiates the effects of insulin and cause blood glucose levels to decrease
Manifestations of hypoglycemia
Hunger, tremors, pallor, fatigue, headache, difficulty thinking, sweating, nausea, cold clammy skin from cholinergic response to central glucose deprivation
SIADH
Hyponatremia caused by the excessive release of ADH, increased water retention, dilution
Manifestations of hyperglycemia in type 2
Increased urination (polyuria) due to insulin deficiency leading to osmotic diuresis Dehydration: dry mucosa, sunken eyes Excess thirst (polydipsia)
Diabetic Ketoacidosis (DKA) lab values
Low pH < 7.3 Bicarbonate < 15 Positive urine ketones Blood glucose > 250
A nurse is planning care for a client who is experiencing Somogyi effect and takes intermittent acting insulin. What should the nurse include in the plan?
Monitor nighttime BG levels The Somogyi effect is a swing of a high blood glucose level in the morning after an extremely low blood glucose level during the night. The swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels over time can provide an accurate diagnosis of the Somogyi effect. Ensure the client receives a bedtime snack to decrease the chance for hypoglycemia during the night Evaluate the client's evening caloric intake based on the insulin dose and exercise programs during the day to avoid conditions that can lead to the Somogyi effect Administer a smaller dose of intermediate-acting insulin at bedtime, or increase the client's bedtime snacks, to avoid conditions that can lead to the Somogyi effect.
A nurse is caring for a client who has diabetes insipidus. What should the nurse monitor for?
Polyuria, polydipsia, low specific gravity (glucose in urine is type 1 DM)
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?
Tachycardia and hypertension: unexpected findings, which can indicate the occurrence of thyroid storm following removal of the thyroid gland, especially if the client was in a hyperthyroid state prior to the surgery. Thyrotoxic, or thyroid storm, is a life-threatening condition with a sudden onset that includes tachycardia, fever, sweating, restlessness, and tremors. Congestive heart failure and pulmonary edema can develop rapidly and lead to death. Laryngeal stridor and hoarseness: unexpected findings and can indicate swelling in the area of the surgery or damage to the laryngeal nerve. This should be reported to the provider before respiratory distress develops. Positive Trousseau's sign: indication of hypocalcemia, which is a complication of thyroid removal. This occurs when the parathyroid glands are also removed and regulation of serum calcium is impaired
A nurse is providing teaching to a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates understanding of the teaching?
Turkey and cheese sandwich Rationale: A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. The client who has Addison's disease requires a diet low in potassium and high in sodium, carbohydrates, and protein. Addison's disease is a hormone deficiency caused by damage to the outer layer of the adrenal gland (adrenal cortex). Addison's disease occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some cases, the hormone aldosterone.
A nurse is planning care for a client who has Cushing's from chronic corticosteroid use. What should the nurse include in the plan of care?
Urine specific gravity to assess for fluid volume overload Hyperglycemia because hypercortisolism elevates blood glucose Weight daily because treatment is dependent on findings
A nurse is monitoring a client who has Grave's disease for the development of thyroid storm. The nurse should report which of the following findings to the provider?
Hypertension Rationale: 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 preparing a 24 hr urine speciment for a pt who is suspected to have pheochromocytoma. Which labs from the specimen should the nurse determine the clients condition?
Vanillylmandelic acid (VMA) The nurse should expect the 24-hr urine specimen to test for VMA. This test is used to determine if the client has pheochromocytoma, which measures the level of catecholamine metabolites in a 24-hr urine sample. Pheochromocytoma 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.
