Nokea
The nurse is caring for a patient with acute adrenal insufficiency. Which of the following findings indicate that the prescribed therapies are effective?
- A. Increasing serum sodium levels
- B. Decreasing blood glucose levels
- C. Decreasing serum chloride levels
- D. Increasing serum potassium levels
Correct Answer: A
Rationale: Clinical manifestations of Addison's disease include hyponatremia and an increase in sodium level indicates improvement. The other values indicate that treatment has not been effective.
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A patient is being treated with a medication to block the effect of antidiuretic hormone to control the symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings indicates that the medication is effective?
- A. Decreased peripheral edema
- B. Increased weight
- C. Increased urine specific gravity
- D. Increased urinary output
Correct Answer: D
Rationale: Agents that block the effect of ADH on the renal tubules may be prescribed, thereby allowing more dilution of urine leading to an increased urine output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a common clinical manifestation of this disorder.
The nurse is admitting a patient to the hospital who is in an Addisonian crisis. Which of the following patient statements support the nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addison's disease?
- A. I double my dose of hydrocortisone on the days that I go for a run.
- B. I frequently eat at restaurants, and so my food has a lot of added salt.
- C. I had the stomach flu earlier this week and couldn't take the hydrocortisone.
- D. I take twice as much hydrocortisone in the morning as I do in the afternoon.
Correct Answer: C
Rationale: The need for hydrocortisone replacement is increased with stressors such as illness, and the patient needs to be taught to call the health care provider because medication and IV fluids and electrolytes may need to be given. The other patient statements indicate appropriate management of the Addison's disease.
The nurse is caring for a patient with Cushing's syndrome who returns to the surgical unit following an adrenalectomy. Which of the following actions during the initial postoperative period has the highest priority?
- A. Monitoring for infection
- B. Protecting the patient's skin
- C. Maintaining fluid and electrolyte status
- D. Preventing severe emotional disturbances
Correct Answer: C
Rationale: After adrenalectomy, the patient is at risk for circulatory instability caused by fluctuating hormone levels, and the focus of care is to assess and maintain fluid and electrolyte status through the use of IV fluids and corticosteroids. The other goals are also important for the patient but are not as immediately life-threatening as the circulatory collapse that can occur with fluid and electrolyte disturbances.
Which of the following information obtained by the nurse when caring for a patient who has diabetes insipidus (DI) is most important to report to the health care provider?
- A. History of a recent head injury
- B. Confusion and lethargy
- C. Urine output of 400 mL/hour
- D. Urine specific gravity is 1.003
Correct Answer: B
Rationale: The patient's confusion and lethargy may indicate hypernatremia and should be addressed quickly. In addition, patients with DI compensate for fluid losses by drinking copious amounts of fluids, but a patient who is lethargic will be unable to drink enough fluids and will become hypovolemic. A high urine output, low urine specific gravity, and history of a recent head injury are consistent with diabetes insipidus, but they do not require immediate nursing action to avoid life-threatening complications.
The nurse is caring for a patient with Graves' disease who has to,2026. 11:3.29. following actionspl. All is included in the plan of care?
- A. Apply eye patches to protect the cornea from irritation.
- B. Place cold packs on the eyes to
- C. Elevate the head of the patient's bed to reduce periorbital
- D. Teach the patient to blink every few seconds to lubric
Correct Answer: C
Rationale: The patient should sit upright as much as possible to promote fluid drainage from the periorbital area. With exophthalmos, the patient is unable to close the eyes completely. Lubrication of the eyes, rather than eye patches, will protect the eyes from developing corneal scarring. The swelling of the eye is not caused by excessive blood flow to the eye, so cold packs will not be helpful.