Clinical Companion to Medical-Surgical Nursing: Endocrine Disorders
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Questions and Answers

What is the primary cause of addisonian crisis in patients with adrenocortical insufficiency?

  • Bilateral adrenalectomy
  • Sudden withdrawal of corticosteroid hormone therapy (correct)
  • Infection
  • Sudden withdrawal of anticoagulant therapy

    • Which of the following is NOT a common manifestation of adrenocortical insufficiency?

  • Hypertension (correct)
  • Anorexia
  • Skin hyperpigmentation
  • Weight loss

    • What is the result of a positive response to ACTH stimulation in patients with adrenocortical insufficiency?

  • A 5% increase in plasma cortisol levels (correct)
  • Low plasma cortisol levels
  • A definitive diagnosis of addisonian crisis
  • A normal response to vasopressors and fluid replacement

    • What is the primary site of skin hyperpigmentation in patients with adrenocortical insufficiency?

    <p>Primarily in sun-exposed areas, at pressure points, and over joints</p> Signup and view all the answers

    Which of the following is a life-threatening complication of adrenocortical insufficiency?

    <p>Addisonian crisis</p> Signup and view all the answers

    What is the typical response to vasopressors and fluid replacement in patients with adrenocortical insufficiency experiencing circulatory collapse?

    <p>No response to vasopressors and fluid replacement</p> Signup and view all the answers

    Which of the following is NOT a trigger for addisonian crisis in patients with adrenocortical insufficiency?

    <p>Physical activity</p> Signup and view all the answers

    What percentage of Addison disease cases in the United States are caused by an autoimmune response?

    <p>80%</p> Signup and view all the answers

    Which of the following hormones are usually sufficient in secondary adrenocortical insufficiency?

    <p>Mineralocorticoids</p> Signup and view all the answers

    What is the term for Addison disease presenting along with other endocrine disorders?

    <p>Autoimmune polyglandular syndrome</p> Signup and view all the answers

    What is the result of an autoimmune response in Addison disease?

    <p>Destruction of the adrenal cortex</p> Signup and view all the answers

    Which of the following is NOT a cause of Addison disease?

    <p>Hypothyroidism</p> Signup and view all the answers

    What is the term for the lack of pituitary adrenocorticotropic hormone (ACTH) secretion?

    <p>Secondary adrenocortical insufficiency</p> Signup and view all the answers

    What is the percentage of the book that is left to read?

    <p>4%</p> Signup and view all the answers

    What is the primary source of androgen production in women?

    <p>Adrenal glands</p> Signup and view all the answers

    What is the primary goal of administering large volumes of 0.9% saline solution and 5% dextrose to a patient in addisonian crisis?

    <p>To reverse hypotension and electrolyte imbalances</p> Signup and view all the answers

    What is the primary reason patients with Addison disease cannot cope with stress?

    <p>Corticosteroids cannot be produced</p> Signup and view all the answers

    What is the recommended approach to caring for a patient with Addison disease in a hospital setting?

    <p>Protecting the patient from noise, bright light, and environmental temperature extremes</p> Signup and view all the answers

    What is the expected outcome of IV high-dose hydrocortisone replacement in a patient hospitalized due to an adrenal crisis?

    <p>Significant improvement by the second day</p> Signup and view all the answers

    What is the primary focus of patient and caregiver teaching for individuals with Addison disease?

    <p>The serious nature of Addison disease and the need for lifelong hormone therapy</p> Signup and view all the answers

    What is the recommended action for patients taking mineralocorticoid therapy?

    <p>Increase salt intake and report significant changes to their healthcare provider</p> Signup and view all the answers

    What is the primary reason for teaching patients with Addison disease to wear a medical identification bracelet and carry a wallet card?

    <p>To ensure appropriate therapy in an emergency</p> Signup and view all the answers

    What is the recommended action for patients with Addison disease who experience vomiting or diarrhea?

    <p>Notify the HCP at once and possibly require electrolyte replacement and IV cortisol administration</p> Signup and view all the answers

    What is the purpose of carrying an emergency kit with 100mg of IM methylprednisolone (Solu-Medrol), syringes, and instructions for use?

    <p>To provide emergency therapy when hormone therapy cannot be taken orally</p> Signup and view all the answers

    Why is it necessary to teach patients with Addison disease about prevention of infection and prompt treatment of existing infections?

    <p>To prevent infections from becoming severe</p> Signup and view all the answers

    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?

    <p>Increase corticosteroid dosage to prevent deficiency</p> Signup and view all the answers

    Why is it essential to provide management instructions for patients with diabetes who take corticosteroids?

    <p>To monitor blood glucose levels and prevent hyperglycemia</p> Signup and view all the answers

    What is the purpose of teaching patients with Addison disease to recognize the signs and symptoms of corticosteroid deficiency and excess?

    <p>To recognize the need for dosage adjustments and contact their HCP</p> Signup and view all the answers

    Which laboratory finding is typically associated with adrenocortical insufficiency?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is the purpose of giving glucocorticoids in divided doses in adrenocortical insufficiency treatment?

    <p>To reflect normal circadian rhythm and decrease side effects</p> Signup and view all the answers

    What is the most commonly used form of hormone therapy in adrenocortical insufficiency treatment?

    <p>Hydrocortisone</p> Signup and view all the answers

    Why is the dosage of glucocorticoids increased in stressful situations in patients with adrenocortical insufficiency?

    <p>To prevent addisonian crisis</p> Signup and view all the answers

    What is the purpose of replacing mineralocorticoids with fludrocortisone in adrenocortical insufficiency treatment?

    <p>To replace mineralocorticoids</p> Signup and view all the answers

    What is the reason for increased BUN levels in patients with adrenocortical insufficiency?

    <p>Dehydration</p> Signup and view all the answers

    What is the purpose of using CT and MRI in patients with adrenocortical insufficiency?

    <p>To localize other causes of adrenocortical insufficiency</p> Signup and view all the answers

    Why is it important to manage the underlying cause of adrenocortical insufficiency?

    <p>To manage the underlying cause when possible</p> Signup and view all the answers

    What is the benefit of giving mineralocorticoids in the morning in adrenocortical insufficiency treatment?

    <p>To reflect normal circadian rhythm</p> Signup and view all the answers

    What is the result of a lack of cortisol and aldosterone in the urine of patients with adrenocortical insufficiency?

    <p>Low levels of cortisol and aldosterone</p> Signup and view all the answers

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