Nokea
A physician has ordered a client to receive growth hormone subcutaneously. Which of the following tests would the nurse anticipate as required at different intervals during the treatment?
- A. Carbohydrate tolerance
- B. Serum electrolyte levels
- C. Glucose tolerance
- D. pH level of the blood
Correct Answer: C
Rationale: Periodic testing of growth hormone levels, glucose tolerance, and thyroid functioning are required during growth hormone treatment for the client. The pH level of blood and carbohydrate tolerance testing are not required. Testing serum electrolyte levels is needed when a client is undergoing vasopressin therapy.
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A physician has prescribed vasopressin to the client for regulating the reabsorption of water by the kidneys. Which of the following assessments should the nurse perform after the administration of vasopressin?
- A. Observe for and report any evidence of edema, such as dyspnea.
- B. Measure and record the client's abdominal girth every hour.
- C. Observe the client for blanching of the skin, abdominal cramps, and nausea.
- D. Weigh the client every day to obtain a baseline weight.
Correct Answer: C
Rationale: After vasopressin is administered to the client, the nurse should observe the client every 10 to 15 minutes for signs of an excessive dosage, which include blanching of the skin, abdominal cramps, and nausea. After corticotropin is administered to the client, the nurse needs to observe for and report any evidence of edema, such as weight gain, rales, increased pulse or dyspnea, or swollen extremities. If the client is receiving vasopressin for abdominal distention, the nurse needs to auscultate the abdomen every 15 to 30 minutes and measure abdominal girth hourly. The nurse needs to weigh the client to obtain a baseline weight for future comparison before administering vasopressin to the client.
A nurse is reviewing the medical history report of a client who is to receive gonadotropins. In which of the following conditions would the use of gonadotropins be contraindicated?
- A. Sensitivity to benzyl alcohol
- B. Epiphyseal closure
- C. Adrenal dysfunction
- D. Epilepsy
Correct Answer: C
Rationale: While reviewing the medical history of the client, the nurse should identify that gonadotropins are contraindicated in clients with adrenal dysfunction, high gonadotropin levels, thyroid dysfunction, liver disease, abnormal bleeding, ovarian cysts, sex-hormone-dependent tumors, or organic intracranial lesions (pituitary tumors). Gonadotropins should be used cautiously in clients with epilepsy. Somatropin growth hormones are contraindicated in clients with sensitivity to benzyl alcohol, epiphyseal closure, and underlying cranial lesions.
A nurse is caring for a client who has been undergoing glucocorticoid therapy at a health care facility and is getting discharged. Which of the following instructions should the nurse include in the teaching plan for the client and family?
- A. Report any symptoms of sore throat or fever immediately.
- B. Notify the PHCP if glucose appears in the urine.
- C. Measure the amount of fluids taken each day.
- D. Take the oral drug with meals or snacks.
Correct Answer: D
Rationale: The nurse should instruct the client to take the oral drug with meals or snacks to decrease the gastrointestinal effects and upsets in the teaching plan for the client and family. Reporting any symptoms of sore throat or fever immediately and notifying the primary health care provider if glucose appears in the urine should be included in the teaching plan for a client undergoing adrenocorticotropic hormone (ACTH) therapy. The nurse should instruct the client to measure the amount of fluids taken each day in the teaching plan for the client receiving vasopressin.
A client is receiving corticosteroid therapy. Which nursing diagnosis would the nurse be least likely to identify for this client?
- A. Risk for Infection
- B. Disturbed Body Image
- C. Risk for Injury
- D. Deficient Fluid Volume
Correct Answer: D
Rationale: A client who is receiving corticosteroid therapy would be least likely to have a nursing diagnosis of Deficient Fluid Volume. Rather, Excess Fluid Volume would be more appropriate. Risk for Infection related to immunosuppression, Disturbed Body Image related to cushingoid effects, and Risk for Injury related to muscle atrophy and osteoporosis would be appropriate.
A nurse is preparing to teach a client about vasopressin. Which of the following would the nurse integrate into the teaching? Select all that apply.
- A. Vasopressin is secreted by the adrenal gland.
- B. Vasopressin is secreted when body fluids must be conserved.
- C. Vasopressin exhibits its greatest activity in the bladder.
- D. Vasopressin regulates the reabsorption of water from the kidney.
- E. Vasopressin is used to treat diabetes mellitus.
Correct Answer: B,D
Rationale: The following is true of the hormone vasopressin: it is secreted by the posterior pituitary gland, is secreted when body fluids must be conserved, exhibits its greatest activity on the renal tubular epithelium, regulates the reabsorption of water from the kidney, and is used to treat diabetes insipidus.