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A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this patients immediate care? Select all that apply.
- A. Administering diuretics to prevent fluid overload
- B. Administering beta blockers to reduce heart rate
- C. Administering insulin to reduce blood glucose levels
- D. Applying interventions to reduce the patients temperature
- E. Administering corticosteroids
Correct Answer: B,D
Rationale: Thyroid storm necessitates interventions to reduce heart rate and temperature. Diuretics, insulin, and steroids are not indicated to address the manifestations of this health problem.
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The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply.
- A. Urine output
- B. Signs or symptoms of venous thromboembolism
- C. Peripheral pulses
- D. Blood pressure
- E. Skin integrity
Correct Answer: A,D
Rationale: The principal action of aldosterone is to conserve body sodium. Alterations in aldosterone levels consequently affect urine output and BP. The patients peripheral pulses, risk of VTE, and skin integrity are not typically affected.
A patient on corticosteroid therapy needs to be taught that a course of corticosteroids of 2 weeks duration can suppress the adrenal cortex for how long?
- A. Up to 4 weeks
- B. Up to 3 months
- C. Up to 9 months
- D. Up to 1 year
Correct Answer: D
Rationale: Suppression of the adrenal cortex may persist up to 1 year after a course of corticosteroids of only 2 weeks duration.
The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem?
- A. Truncal obesity
- B. Hypertension
- C. Muscle weakness
- D. Moon face
Correct Answer: C
Rationale: Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?
- A. Do you feel any muscle twitches or spasms?
- B. Do you feel flushed or sweaty?
- C. Are you experiencing any dizziness or lightheadedness?
- D. Are you having any pain that seems to be radiating from your bones?
Correct Answer: A
Rationale: As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?
- A. The possibility of precipitous weight gain
- B. The need for lifelong steroid replacement
- C. The need to match the daily steroid dose to immediate symptoms
- D. The importance of monitoring liver function
Correct Answer: B
Rationale: Because of the need for lifelong replacement of adrenal cortex hormones to prevent addisonian crises, the patient and family members receive explicit education about the rationale for replacement therapy and proper dosage. Doses are not adjusted on a short-term basis. Weight gain and hepatotoxicity are not common adverse effects.