Endocrine disorders

Question 1

In acromegaly, what is the purpose of the glucose-tolerance test? what does it measure

Answer 1

growth hormone concentration

Question 2

what is the pre-operative teaching for a patient scheduled for transphenoidal hypophysectomy?

Answer 2

a pituitary tumor will be removed - no sneezing after the procedure

Question 3

An excess of what hormone causes the large flattened features of the patient with acromegaly?

Answer 3

growth hormone

Question 4

what are the classic signs and symptoms of diabetes insipidus?

Answer 4

problem with posterior pituitary

massive diuresis, excessive thirst, very dilute urine. Massive dehydration.

Question 5

why must a patient with Addison Disease take hydrocortisone?

Answer 5

regulate the excretion of potassium and sodium

Question 6

what is nephrogenic DI and how does it differ from neurogenic DI?

Answer 6

nephrogenic does not respond to ADH and is inherited. Neurogenic is caused by a tumor, or cancer, or trauma

Question 7

Why would a patient with Addison disease have a disturbed body image related to the color of their skin?

Answer 7

hyperpigmentation. bronze or smoky color skin

Question 8

what is the cardinal indication of pheochromocytoma?

Answer 8

its a tumor in the adrenal glands, usually benign, excessive secretion of catecholamines. epinephrine and norepinephrine. Diastolic BP over 115

Question 9

what are the signs and symptoms of an Adrenal crisis for a patient with Addison’s disease?

Answer 9

confusion, it is life threatening. electrolyte imbalances, hypoglycemia, tachycardia

Question 10

What is the purpose of the lab test to measure the serum level of adrenocorticotropic hormone (ACTH)?

Answer 10

it is measured to detect elevations of deficiencies in pituitary hormones. Making sure the pituitary gland is sending the right message to the adrenaline gland to release the correct level of ACTH

Question 11

what would be included in the discharge plan for a patient with Addison Disease related to risk for injury?

Answer 11

if they are dizzy, arise slowly, call for help before getting out of bed

Question 12

why would a patient in adrenal crisis, after receiving the initial dose of IV Solu Cortef, need continued IV Solu Cortef?

Answer 12

to maintain blood levels

Question 13

what would the nurse include in the teaching plan for a patient who has Addison Disease?

Answer 13

wear a medical alert bracelet.

Question 14

What medication would cause a long term asthma patient to develop Cushing Syndrome?

Answer 14

corticosteroids

Question 15

what are the expected findings when assessing a patient with Cushing Syndrome?

Answer 15

moon face, trunk obesity, extremity wastng, buffalo hump, swelling

Question 16

What instructions would the nurse give a patient with Cushing Syndrome regarding self care?

Answer 16

avoid people with infections

Question 17

what should a nurse anticipate when assessing a patient with Simmonds Cachexia, related to hypopituitarism?

Answer 17

muscle and organ wasting

Question 18

in documenting a care plan for a 10 year old boy with hyperpituitarism, know what the nurse would tell the patient related to disturbed self image

Answer 18

they will continue to grow, increased growth

Question 19

what is the nursing care for a patient who had a hypophysectomy, in which the whole pituitary was removed?

Answer 19

hormone replacement for life

Question 20

What are the caused for an Addisonian Crisis?

Answer 20

adrenal surgery, pituitary destruction, stress and abrupt steroid removal

Question 21

what is the discharge planning for the patient who underwent a hypophysectomy is focused on?

Answer 21

avoid straining, heavy lifting, self care

Question 22

What nursing responses from the nurse would be best for the patient’s family and the patient if the patient has gigantism

Answer 22

hyper pituitary acceptance

Question 23

for a patient with hypopituitarism, who must take medications for the rest of their life, what would the teaching plan include?

Answer 23

to be educated on signs and symptoms to know if meds are working affectively. Medical alert bracelet, signs of water toxicity

Question 24

what is the drug Sandostatin for and how does it work?

Answer 24

acromegaly and it suppresses the growth hormone

Question 25

If a patient complains of headache and nuchal rigidity after a hypophysectomy, based on these assessments, what should the nurse do?

Answer 25

meningeal irritation, report it to the physician

Question 26

If a physician orders a T3 and T4, know what levels of these tests would indicate hypothyroidism?

Answer 26

decreased/low

Question 27

if a patient starts taking potassium iodide SSKI, know what the nurse should instruct the patient to do?

Answer 27

use a straw - to prevent staining teeth

Question 28

if a patient with hyperthyroid, cannot get to sleep, know what the nurse should suggest?

Answer 28

encourage bedtime rituals

Question 29

know what significant instructions to give a patient who is scheduled for a thyroid scan?

Answer 29

wash hands with soap and water every time you go to the bathroom for 24 hours because of the radiation

Question 30

if a patient had a lab test that showed a high level of thyroid-stimulating hormone (TSH) and a low level of T4, know what that would indicate?

Answer 30

hypothyroidism

Question 31

know what "exophthalmos" is and when it goes away?

Answer 31

bulging eyes, goes away after treatment

Question 32

know the pathophysiology of Graves Disease and how to explain that to a patient?

Answer 32

hyperthyroidism - subtotal thyroidectomy, remove most of it. Lifelong medications

Question 33

if a patient was 1 day post-op after subtotal thyroidectomy and noted the patient's color was poor, pulse and respirations were rapid and the patient felt war to touch, know what the nurses initial implementation should be

Answer 33

thyroid storm

Question 34

if a patient had been given the drug "propylthiouracil" know what nursing implementations should include

Answer 34

used for hyperthyroidism, watch for hypothyroidism, weight gain and fatigue

Question 35

know what an appropriate nursing diagnosis for a patient recently diagnosed with hyperthyroidism would be

Answer 35

decreased cardiac output, disturbed sleep pattern, hyperthermia, imbalanced nutrition: less than body requirement, risk for injury, disturbed sensory perception, diarrhea

Question 36

a newly diagnosed patient with hypothyroidism begins a drug regimen, know what nurse instructions should be given relative to hormone replacement

Answer 36

watch for hyperthyroidism

Question 37

what pre-surgical teaching is included for a patient scheduled for a sub-total thyroidectomy

Answer 37

demonstrate how to avoid straining the neck support the head and neck during position changes cough and deep breathe

Question 38

after a patient undergoes thyroidectomy, know what explanation you would give the patient for the tracheostomy tray on the bedside table

Answer 38

in case of an emergency, the larynx can spasm and close the airway

Question 39

How should a nurse asses for hemorrhage in a post thyroidectomy patient?

Answer 39

assess dressing, check back of the neck for seeping blood put in high fowlers to prevent swelling

Question 40

how do foods such as soybeans, turnips and rutabagas have an effect on a person with a thyroid disorder?

Answer 40

suppresses the thyroid

Question 41

why might an older persons daily dose of thyroid hormone, taken for many years, need to be decreased?

Answer 41

metabolism may decrease, so decrease hormone

Question 42

a patient who is 2 days post-op total thyroidectomy, has a carpopedal spasm of the hand. know why this would occur and what the spasm is called

Answer 42

low calcium, hypocalcemia

Question 43

how does the nurse initiate "chvostek sign" and what does it indicate?

Answer 43

facial nerve, spasm of facial muscle, hypocalcemia

Question 44

what would a patient with hyperparathyroidism exhibit in their history

Answer 44

impaired urinary elimination due to renal calculi

Question 45

if a patient who has hyperparathyroidism is to receive the drug Calcitonin (calcimar), know what the patient should be tested for, before receiving this drug

Answer 45

sensitivity

Question 46

what is an appropriate nursing diagnosis for a patient with hyperparathyroidism?

Answer 46

impaired urinary elimination related to urinary calculi