Nokea
A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient?
- A. Increased body temperature
- B. Jaundice
- C. Copious urine output
- D. Decreased BP
Correct Answer: D
Rationale: Decreased BP may occur with hypofunction of the adrenal cortex. Decreased function of the adrenal cortex does not affect the patients body temperature, urine output, or skin tone.
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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 suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding?
- A. The patients pituitary function is compromised
- B. The patients adrenal insufficiency is not treatable
- C. The patient has insufficient hypothalamic function
- D. The patient would benefit from surgery
Correct Answer: A
Rationale: An adrenal response to the administration of a stimulating hormone suggests inadequate production of the stimulating hormone. In this case, ACTH is produced by the pituitary and, consequently, pituitary hypofunction is suggested. Hypothalamic function is not relevant to the physiology of this problem. Treatment exists, although surgery is not likely indicated.
The nurses assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?
- A. Oral calcium chloride and vitamin D
- B. IV calcium gluconate
- C. STAT levothyroxine
- D. Administration of parathyroid hormone (PTH)
Correct Answer: B
Rationale: When hypocalcemia and tetany occur after a thyroidectomy, the immediate treatment is administration of IV calcium gluconate. This has a much faster therapeutic effect than PO calcium or vitamin D supplements. PTH and levothyroxine are not used to treat this complication.
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.
The nurse is planning the care of a patient with hyperthyroidism. What should the nurse specify in the patients meal plan?
- A. A clear liquid diet, high in nutrients
- B. Small, frequent meals, high in protein and calories
- C. Three large, bland meals a day
- D. A diet high in fiber and plant-sourced fat
Correct Answer: B
Rationale: A patient with hyperthyroidism has an increased appetite. The patient should be counseled to consume several small, well-balanced meals. High-calorie, high-protein foods are encouraged. A clear liquid diet would not satisfy the patients caloric or hunger needs. A diet rich in fiber and fat should be avoided because these foods may lead to GI upset or increase peristalsis.