Nokea
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.
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While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patients vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?
- A. Hyperthermia and tachypnea
- B. Hypertension and heart rate changes
- C. Hypotension and hypothermia
- D. Hyperthermia and bradycardia
Correct Answer: B
Rationale: Manipulation of the tumor during surgical excision may cause release of stored epinephrine and norepinephrine, with marked increases in BP and changes in heart rate. The use of sodium nitroprusside and alpha-adrenergic blocking agents may be required during and after surgery. While other vital sign changes may occur related to surgical complications, the most common changes are related to hypertension and changes in the heart rate.
Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?
- A. Episodes of high psychosocial stress
- B. Periods of dehydration
- C. Episodes of physical exertion
- D. Administration of a vaccine
Correct Answer: A
Rationale: During stressful procedures or significant illnesses, additional supplementary therapy with glucocorticoids is required to prevent addisonian crisis. Physical activity, dehydration and vaccine administration would not normally be sufficiently demanding such to require glucocorticoids.
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.
The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
- A. Symptoms of hypothyroidism extreme fatigue, hair loss, brittle nails, dry skin, voice huskiness or hoarseness, menstrual disturbance
- B. Bulging eyes
- C. Palpitations
- D. Flushed skin
Correct Answer: A
Rationale: Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers. Bulging eyes, palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.
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.