Nokea
A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?
- A. The patients diet should be low protein with ample fat
- B. The patient may experience short-term changes in cognition
- C. The patient is at an increased risk for developing infection
- D. The patient is at a decreased risk for development of thrombophlebitis and thromboembolism
Correct Answer: C
Rationale: The patient is at increased risk of infection and masking of signs of infection. The cardiovascular effects of corticosteroid therapy may result in development of thrombophlebitis or thromboembolism. Diet should be high in protein with limited fat. Changes in appearance usually disappear when therapy is no longer necessary. Cognitive changes are not common adverse effects.
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A patient with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?
- A. Blood glucose
- B. Assessment of urine for blood
- C. Weight
- D. Oral temperature
Correct Answer: A
Rationale: Before, during, and after this surgery, blood glucose monitoring and assessment of stools for blood are carried out. The patients blood sugar is more likely to be volatile than body weight or temperature. Hematuria is not a common complication.
A patient has been assessed for aldosteronism and has recently begun treatment. What are priority areas for assessment that the nurse should frequently address? Select all that apply.
- A. Pupillary response
- B. Creatinine and BUN levels
- C. Potassium level
- D. Peripheral pulses
- E. BP
Correct Answer: C,E
Rationale: Patients with aldosteronism exhibit a profound decline in the serum levels of potassium, and hypertension is the most prominent and almost universal sign of aldosteronism. Pupillary response, peripheral pulses, and renal function are not directly affected.
A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patients diminished thyroid function may have what effect?
- A. Anaphylaxis
- B. Nausea and vomiting
- C. Increased risk of drug interactions
- D. Prolonged duration of effect
Correct Answer: D
Rationale: In all patients with hypothyroidism, the effects of analgesic agents, sedatives, and anesthetic agents are prolonged. There is no direct increase in the risk of anaphylaxis, nausea, or drug interactions, although these may potentially result from the prolonged half-life of drugs.
A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?
- A. Side-lying (lateral) with one pillow 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. Supine, with a small roll supporting the neck
Correct Answer: C
Rationale: When moving and turning the patient, the nurse carefully supports the patients head and avoids tension on the sutures. The most comfortable position is the semi-Fowlers position, with the head elevated and supported by pillows.
A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patients care?
- A. Decisional conflict related to treatment options
- B. Spiritual distress related to changes in cognitive function
- C. Disturbed body image related to changes in physical appearance
- D. Powerlessness related to disease progression
Correct Answer: C
Rationale: Cushing syndrome causes characteristic physical changes that are likely to result in disturbed body image. Decisional conflict and powerless may exist, but disturbed body image is more likely to be present. Cognitive changes take place in patients with Cushing syndrome, but these may or may not cause spiritual distress.