Nokea
A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called?
- A. Hypophysectomy
- B. Hysteroscopy
- C. Thyroidectomy
- D. Ablation
Correct Answer: A
Rationale: The treatment of choice is surgical removal of the pituitary gland (transsphenoidal hypophysectomy) through a nasal approach. The surgeon may substitute an endoscopic technique using microsurgical instruments to reduce surgical trauma. A hysteroscopy is a gynecologic procedure. The thyroid gland is not involved for a surgical procedure. Ablation is not a removal of the pituitary gland.
You may also like to solve these questions
A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?
- A. Glaucoma
- B. Corneal abrasions
- C. Retinal detachment
- D. Pressure on the optic nerve
Correct Answer: D
Rationale: Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur suddenly, and the client did not report injury to suspect corneal abrasions or retinal detachment.
A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?
- A. Measuring the urine output every 30 minutes
- B. Monitoring the rate of IV infusions
- C. Measuring the fluid intake
- D. Weighing the client daily
Correct Answer: A
Rationale: The nurse must measure the urine output every 30 minutes when administering prescribed fluid and drug therapy when the client is acutely ill or extremely dehydrated, fails to take oral fluids, or is beginning to receive medical treatment. Doing so ensures adequate kidney function. Although monitoring the rate of IV infusions, measuring fluid intake, and weighing the client daily are important, measuring the urine output every 30 minutes is the priority.
The nurse is instructing a client about the use of pegvisomant for the treatment of acromegaly. How will the nurse instruct to take this medication?
- A. Injected subcutaneously once a day
- B. Injected intramuscularly once a month
- C. Administer via an implanted port once a month
- D. Injected intramuscularly one every 6 months
Correct Answer: A
Rationale: Pegvisomant, a GH receptor antagonist, is the newest and most effective drug for treating acromegaly. Injected subcutaneously once a day, it normalizes the IGF-I level in 93% to 97% of cases by blocking the GH stimulation of IGF-I produced by the liver.
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as resulting in which condition?
- A. Gigantism
- B. Dwarfism
- C. Acromegaly
- D. Simmonds disease
Correct Answer: A
Rationale: When oversecretion of GH occurs before puberty, gigantism results. Dwarfism occurs when secretion of GH is insufficient during childhood. Oversecretion of GH during adulthood results in acromegaly. An absence of pituitary hormonal activity causes Simmonds disease.
The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- D. Diabetes insipidus (DI)
Correct Answer: B
Rationale: Clients with hyperthyroidism characteristically are restless despite feeling fatigued and weak, highly excitable, and constantly agitated. Fine tremors of the hand occur, causing unusual clumsiness. The client cannot tolerate heat and has an increased appetite but loses weight. Diarrhea also occurs. Visual changes, such as blurred or double vision, can develop. Exophthalmos, seen in clients with severe hyperthyroidism, results from enlarging muscle and fatty tissue surrounding the rear and sides of the eyeball. Hypothyroidism clinical manifestations are the opposite of what is seen in hyperthyroidism, and SIADH and DI clinical manifestations do not correlate with the symptoms manifested by the client.