38 Questions
What is the primary cause of addisonian crisis in patients with adrenocortical insufficiency?
Sudden withdrawal of corticosteroid hormone therapy
Which of the following is NOT a common manifestation of adrenocortical insufficiency?
Hypertension
What is the result of a positive response to ACTH stimulation in patients with adrenocortical insufficiency?
A 5% increase in plasma cortisol levels
What is the primary site of skin hyperpigmentation in patients with adrenocortical insufficiency?
Primarily in sun-exposed areas, at pressure points, and over joints
Which of the following is a life-threatening complication of adrenocortical insufficiency?
Addisonian crisis
What is the typical response to vasopressors and fluid replacement in patients with adrenocortical insufficiency experiencing circulatory collapse?
No response to vasopressors and fluid replacement
Which of the following is NOT a trigger for addisonian crisis in patients with adrenocortical insufficiency?
Physical activity
What percentage of Addison disease cases in the United States are caused by an autoimmune response?
80%
Which of the following hormones are usually sufficient in secondary adrenocortical insufficiency?
Mineralocorticoids
What is the term for Addison disease presenting along with other endocrine disorders?
Autoimmune polyglandular syndrome
What is the result of an autoimmune response in Addison disease?
Destruction of the adrenal cortex
Which of the following is NOT a cause of Addison disease?
Hypothyroidism
What is the term for the lack of pituitary adrenocorticotropic hormone (ACTH) secretion?
Secondary adrenocortical insufficiency
What is the percentage of the book that is left to read?
4%
What is the primary source of androgen production in women?
Adrenal glands
What is the primary goal of administering large volumes of 0.9% saline solution and 5% dextrose to a patient in addisonian crisis?
To reverse hypotension and electrolyte imbalances
What is the primary reason patients with Addison disease cannot cope with stress?
Corticosteroids cannot be produced
What is the recommended approach to caring for a patient with Addison disease in a hospital setting?
Protecting the patient from noise, bright light, and environmental temperature extremes
What is the expected outcome of IV high-dose hydrocortisone replacement in a patient hospitalized due to an adrenal crisis?
Significant improvement by the second day
What is the primary focus of patient and caregiver teaching for individuals with Addison disease?
The serious nature of Addison disease and the need for lifelong hormone therapy
What is the recommended action for patients taking mineralocorticoid therapy?
Increase salt intake and report significant changes to their healthcare provider
What is the primary reason for teaching patients with Addison disease to wear a medical identification bracelet and carry a wallet card?
To ensure appropriate therapy in an emergency
What is the recommended action for patients with Addison disease who experience vomiting or diarrhea?
Notify the HCP at once and possibly require electrolyte replacement and IV cortisol administration
What is the purpose of carrying an emergency kit with 100mg of IM methylprednisolone (Solu-Medrol), syringes, and instructions for use?
To provide emergency therapy when hormone therapy cannot be taken orally
Why is it necessary to teach patients with Addison disease about prevention of infection and prompt treatment of existing infections?
To prevent infections from becoming severe
What is the recommended action for patients with Addison disease who engage in rigorous physical activity, such as playing sports on a hot day or distance running?
Increase corticosteroid dosage to prevent deficiency
Why is it essential to provide management instructions for patients with diabetes who take corticosteroids?
To monitor blood glucose levels and prevent hyperglycemia
What is the purpose of teaching patients with Addison disease to recognize the signs and symptoms of corticosteroid deficiency and excess?
To recognize the need for dosage adjustments and contact their HCP
Which laboratory finding is typically associated with adrenocortical insufficiency?
Hyperkalemia
What is the purpose of giving glucocorticoids in divided doses in adrenocortical insufficiency treatment?
To reflect normal circadian rhythm and decrease side effects
What is the most commonly used form of hormone therapy in adrenocortical insufficiency treatment?
Hydrocortisone
Why is the dosage of glucocorticoids increased in stressful situations in patients with adrenocortical insufficiency?
To prevent addisonian crisis
What is the purpose of replacing mineralocorticoids with fludrocortisone in adrenocortical insufficiency treatment?
To replace mineralocorticoids
What is the reason for increased BUN levels in patients with adrenocortical insufficiency?
Dehydration
What is the purpose of using CT and MRI in patients with adrenocortical insufficiency?
To localize other causes of adrenocortical insufficiency
Why is it important to manage the underlying cause of adrenocortical insufficiency?
To manage the underlying cause when possible
What is the benefit of giving mineralocorticoids in the morning in adrenocortical insufficiency treatment?
To reflect normal circadian rhythm
What is the result of a lack of cortisol and aldosterone in the urine of patients with adrenocortical insufficiency?
Low levels of cortisol and aldosterone
This quiz covers the clinical manifestations of endocrine disorders, including symptoms related to anticoagulant therapy, chemotherapy, and bilateral adrenalectomy. Topics include anorexia, nausea, skin hyperpigmentation, and other symptoms. Test your knowledge of medical-surgical nursing!
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