Questions and Answers
Which of the following findings should the nurse expect in a client requiring lifelong hormone replacement therapy for the treatment of hypothyroidism?
What sodium level should the nurse report for a client who has syndrome of inappropriate antidiuretic hormone (SIADH)?
110 mEq/L
What should a client scheduled for a vanillylmandelic acid test restrict from their diet prior to the test?
Coffee intake
What finding should the nurse assess as an indication of hypocalcemia following a thyroidectomy?
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What blood glucose level is an expected finding of diabetic ketoacidosis (DKA)?
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What laboratory values should the nurse expect for a client with diabetic ketoacidosis (DKA)?
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Which of the following adverse effects of long-term corticosteroid therapy should the nurse include in teaching? (Select all that apply)
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What laboratory finding should the nurse expect in a client experiencing a hyperglycemic-hyperosmolar state (HHS)?
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What indicates understanding of glycosylated hemoglobin (HbA1c) testing?
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What skin finding should the nurse expect in a hypoglycemic client?
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What instruction should be included for a client using intranasal desmopressin for diabetes insipidus?
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What is the appropriate action for a nurse managing a client with acute adrenal insufficiency postoperatively?
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What should a nurse teaching a client with type 1 diabetes include about alcohol consumption?
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What calcium level should a nurse expect in a client with adrenal insufficiency?
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What finding is anticipated in a client with hyperthyroidism?
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What respiratory finding should be reported in a client who is 24 hours postoperative following a total thyroidectomy?
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What indicates a therapeutic outcome of insulin therapy in a diabetic client?
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What finding indicates effectiveness of propylthiouracil treatment?
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What should discharge teaching for a client with diabetes insipidus include regarding nasal spray use?
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What action should a nurse recommend to a diabetic client with peripheral neuropathy to prevent foot injuries?
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What indicates therapeutic response to propranolol in a client having a thyroid storm?
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What laboratory finding should the nurse expect when screening for primary Cushing's disease?
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What action should a nurse take for a client with a pheochromocytoma?
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What disorder is assessed by the adrenocorticotropic hormone (ACTH) stimulation test?
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What finding should the nurse expect in a client with Cushing's disease?
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What should a client with diabetes mellitus know about drawing insulin?
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What hematocrit level change should a nurse expect in a client with diabetes insipidus?
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What foot care instruction should a client with a diabetic foot ulcer follow?
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What instruction should a nurse provide for a client following a thyroidectomy regarding medication?
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Study Notes
Hypothyroidism and Hormone Replacement
- Lifelong hormone replacement is essential for treating hypothyroidism; non-adherence may lead to hypotension and other symptoms.
- Common findings in hypothyroidism include bradypnea, cold intolerance, and cool, dry skin.
SIADH
- SIADH causes fluid retention leading to dilutional hyponatremia; a sodium level of 110 mEq/L is critical and should be reported.
Pheochromocytoma Testing
- Prior to a vanillylmandelic acid test, clients should restrict coffee, tea, bananas, chocolate, and vanilla for 2 to 3 days to ensure accurate results.
Thyroidectomy Care
- Following a thyroidectomy, assess for hypocalcemia symptoms; tingling and numbness in hands and feet indicate low calcium levels.
Diabetic Ketoacidosis (DKA)
- DKA is characterized by blood glucose levels exceeding 300 mg/dL; metabolic acidosis is common, with typical lab values of pH 7.32 and HCO3 14 mEq/L.
Long-term Effects of Corticosteroids
- Long-term corticosteroid therapy may lead to osteoporosis, a moon-shaped face (indicative of Cushing's syndrome), and increased infection risk due to immune suppression.
Hyperglycemic-Hyperosmolar State (HHS)
- In HHS, although blood glucose is elevated (over 600 mg/dL), serum pH stays within normal range around 7.45 since ketosis does not occur.
HbA1c Testing
- HbA1c reflects average blood glucose levels over 120 days, providing insight into long-term glycemic control.
Hypoglycemia Symptoms
- In cases of hypoglycemia, expect cool, clammy skin, along with anxiety, nervousness, tachycardia, and confusion.
Diabetes Insipidus Management
- Document nocturia when administering desmopressin; dosage adjustments might be needed based on this symptom.
Postoperative Acute Adrenal Insufficiency
- Administer IV hydrocortisone sodium to treat cortisol deficiency following adrenal insufficiency during postoperative care.
Alcohol and Diabetes
- Advise clients with type 1 diabetes to eat food while drinking alcohol to mitigate the risk of hypoglycemia, as alcohol can reduce gluconeogenesis.
Adrenal Insufficiency Findings
- Expected lab finding in adrenal insufficiency includes elevated calcium levels, with a lab value often exceeding 12.8 mg/dL.
Hyperthyroidism Symptoms
- Typical findings of hyperthyroidism consist of tremors, diaphoresis, and insomnia indicating increased metabolism.
Airway Complications Post-Thyroidectomy
- Monitor for laryngeal stridor after total thyroidectomy as it indicates potential airway obstruction; immediate action is required.
Insulin Therapy Efficacy
- Fasting blood glucose levels of 96 mg/dL show a therapeutic outcome of insulin therapy, within a normal range of 70 to 110 mg/dL.
Propylthiouracil Effectiveness
- Effectiveness of propylthiouracil for hyperthyroidism can be indicated by increased body weight due to reduced thyroid hormone levels.
Desmopressin Administration
- For optimal effects of desmopressin nasal spray, instruct clients to gently blow their nose before use to avoid medication dilution.
Illness and Blood Glucose
- Diabetic clients should contact their healthcare provider if blood glucose levels exceed 250 mg/dL during illness as changes may occur.
Foot Care for Peripheral Neuropathy
- Recommend monitoring bath water temperature using a thermometer to prevent injury, since peripheral neuropathy may impair sensation.
Propranolol in Thyroid Storm
- Propranolol reduces excessive heart rate in thyroid storm by mitigating the effects of thyroid hormones on cardiac function.
Cushing's Disease Screening
- Elevated blood glucose levels are expected in clients with Cushing's disease due to increased cortisol production.
Pheochromocytoma Management
- Elevating the head of the client's bed is a non-invasive way to help manage elevated blood pressure and reduce abdominal pressure.
ACTH Stimulation Test
- The ACTH stimulation test is conducted to assess for Addison's disease, measuring cortisol response to ACTH.
Cushing's Disease Symptoms
- Hirsutism, or increased hair growth, is a characteristic symptom of Cushing's disease resulting from elevated androgen levels.
Insulin Administration Guidelines
- Insulin glargine should be drawn into separate syringes from other insulins due to compatibility issues.
Diabetes Insipidus Indicators
- Clients with diabetes insipidus commonly show increased hematocrit levels due to dehydration from excessive urination.
Diabetic Foot Ulcer Care
- Clients should apply lotion to dry areas of their feet but avoid putting it between toes to prevent bacterial infections.
Thyroid Hormone Replacement Instructions
- Clients should take thyroid hormone replacement medications on an empty stomach for optimal absorption, avoiding food intake for 30 to 60 minutes following the dose.
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Description
This quiz covers key concepts related to various endocrine disorders such as hypothyroidism, SIADH, pheochromocytoma, and diabetic ketoacidosis. Additionally, it explores important aspects of thyroidectomy care and the long-term effects of corticosteroids. Test your understanding of these critical health topics.
