Endocrine System and Disorders

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Questions and Answers

A patient with suspected Cushing's syndrome is undergoing initial screening. Which of the following tests, if elevated, would suggest that the patient has Cushing's syndrome?

  • 24-hour urinary free cortisol (correct)
  • ACTH stimulation test
  • Serum sodium
  • Fasting blood glucose

Following a transsphenoidal hypophysectomy, a patient reports a persistent headache and increased nasal drainage. Which of the following complications should the nurse suspect?

  • Syndrome of inappropriate antidiuretic hormone (SIADH)
  • Meningitis (correct)
  • Cerebral salt wasting
  • Diabetes insipidus

A patient is prescribed desmopressin for the treatment of diabetes insipidus. Which of the following instructions is most important for the nurse to include in the patient's teaching plan?

  • Monitor for signs of hyperkalemia.
  • Increase sodium intake to prevent hyponatremia.
  • Take the medication on an empty stomach to enhance absorption.
  • Restrict fluid intake to prevent water intoxication. (correct)

A patient with a history of hyperparathyroidism is admitted with severe fatigue, bone pain, and nausea. Which of the following electrolyte imbalances is most likely contributing to these clinical manifestations?

<p>Hypercalcemia (C)</p> Signup and view all the answers

A patient is started on levothyroxine for the treatment of hypothyroidism. Which of the following assessment findings indicates the medication is having a therapeutic effect?

<p>Decreased heart rate (A)</p> Signup and view all the answers

A patient with diabetes mellitus is prescribed regular insulin and insulin lispro. Which of the following injection strategies should the nurse teach the patient to minimize the risk of hypoglycemia?

<p>Administer insulin lispro 15 minutes before meals and regular insulin 30 minutes before meals. (A)</p> Signup and view all the answers

A patient with adrenal insufficiency is prescribed hydrocortisone. The nurse should provide which of the following instructions regarding medication administration?

<p>Double the dose during periods of stress such as illness or surgery. (D)</p> Signup and view all the answers

A patient who had a thyroidectomy is now exhibiting signs of tetany. Which electrolyte imbalance is the most likely cause of this condition?

<p>Hypocalcemia (A)</p> Signup and view all the answers

A patient is hospitalized for diabetic ketoacidosis (DKA). Which of the following assessment findings is most important for the nurse to report immediately to the healthcare provider?

<p>Serum potassium of 2.9 mEq/L (A)</p> Signup and view all the answers

A patient with acromegaly is scheduled for an MRI to evaluate the pituitary gland. What specific patient preparation should the nurse include prior to the MRI?

<p>Instructing the patient to avoid wearing metal objects during the scan. (C)</p> Signup and view all the answers

A patient will start taking metformin to manage type 2 diabetes mellitus. The nurse recognizes that which of the following statements about metformin is most accurate?

<p>Metformin improves insulin sensitivity and reduces glucose production in the liver. (D)</p> Signup and view all the answers

A patient receiving propylthiouracil (PTU) for hyperthyroidism develops a fever and sore throat. The nurse should immediately assess for which of the following adverse effects?

<p>Agranulocytosis (A)</p> Signup and view all the answers

A patient with type 2 diabetes mellitus develops several small ulcers on their lower extremities. Which of the following macrovascular complications is the most likely cause of these ulcers?

<p>Peripheral artery disease (B)</p> Signup and view all the answers

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following nursing interventions is most important to implement?

<p>Monitoring for signs of fluid overload (D)</p> Signup and view all the answers

A patient is prescribed glucagon-like peptide-1 (GLP-1) receptor agonist medication. What best describes the mechanism of action of GLP-1 receptor agonists in managing diabetes?

<p>Enhancing insulin secretion. (C)</p> Signup and view all the answers

A patient is being treated for hyperthyroidism with radioactive iodine (RAI). Which teaching point is most important for the nurse to emphasize to the patient?

<p>Avoid close contact with pregnant women and infants for several days. (C)</p> Signup and view all the answers

A patient is diagnosed with Addison's disease. Which nursing intervention is most important to include in the patient's plan of care?

<p>Administering hormone replacement therapy as prescribed. (A)</p> Signup and view all the answers

A patient with diabetes mellitus reports taking garlic supplements to help lower blood sugar. Which is the most appropriate response of the nurse to the patient?

<p>&quot;Additional research is needed to determine the effect of garlic supplements.&quot; (C)</p> Signup and view all the answers

The nurse is reviewing the lab results of a patient with primary hyperaldosteronism. Which findings should the nurse expect to see?

<p>Hypokalemia and hypernatremia (C)</p> Signup and view all the answers

Which of the following statements best describes the negative feedback loop involved in regulating thyroid hormone production?

<p>High levels of thyroid hormones inhibit the release of TSH, which decreases thyroid hormone production. (D)</p> Signup and view all the answers

Flashcards

Negative Feedback Loop

A process where the product of a reaction inhibits the reaction itself.

Pituitary Disorders: Patient Teaching

Diet, post-operative nursing and teaching for transsphenoidal hypophysectomy.

Transsphenoidal Hypophysectomy

Surgical approach through the nasal cavity to remove a pituitary tumor.

Adrenal Disorders: Clinical Manifestations

Manifestations include hypercortisolism and hyperaldosteronism.

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Adrenal Disorders: Patient Education

Education about cause of symptoms for Cushing's and adrenal insufficiency.

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Adrenal Disorders: Steroid Effects

Adverse reactions and prophylactic medication to reduce effects.

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Thyroidectomy Post-Op Care

Observations to report immediately post thyroidectomy, priority actions for thyroid crisis

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Thyroid Disorders: Treatment

Treatment for hypothyroidism and hyperthyroidism.

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Parathyroid Disorders: Manifestations & Treatment

Clinical manifestations and treatment of hypoparathyroidism and hyperparathyroidism.

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Diabetes: HgbA1c Prep

Patient preparation for hemoglobin A1c testing.

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Diabetes: Insulin Administration

Appropriate insulin syringe selection (teaching, technique, & safety)

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Diabetes: DKA Assessment & Treatment

Assessment findings and treatment protocols for diabetic ketoacidosis.

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DM Type 2 Macrovascular Complications

Complications affecting large blood vessels in type 2 diabetes.

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Pharmacology: Medication Information

Indications, route, action, therapeutic & adverse effects of meds.

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Pharmacology: Patient Education

Providing education on all listed medications, including indications and adverse effects.

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Levothyroxine

Medications used to treat hypothyroidism.

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TZDs (Thiazolidinediones)

Thiazolidinediones, like pioglitazone, for type 2 diabetes.

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Biguanides

Biguanides, such as metformin, that reduce glucose production.

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Sulfonylureas

Sulfonylureas, such as glipizide, that stimulate insulin release.

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GLP-1 Agonists

GLP-1 receptor agonists that enhance insulin secretion and reduce glucagon.

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Study Notes

  • The unit contains questions regarding endocrine assessment, pituitary disorders, adrenal disorders, thyroid and parathyroid disorders, diabetes mellitus, pharmacology, and math.

Endocrine Assessment

  • Focus on the negative feedback loop
  • Focus on assessment data requiring immediate intervention
  • Focus on clinical manifestations or physiologic responses related to alterations in various hormones (ADH, GH, cortisol).
  • Focus on age related changes
  • Focus on MRI patient preparation.
  • Focus on patient teaching for steroids.

Pituitary Disorders

  • Focus on patient teaching regarding diet.
  • Focus on transsphenoidal hypophysectomy post-op nursing care and teaching.
  • Focus on nursing diagnoses for various pituitary disorders
  • Focus on electrolyte values.
  • Focus on the most concerning findings related to deficient hormone (ACTH).

Adrenal Disorders

  • Focus on clinical manifestations of hypercortisolism and hyperaldosteronism.
  • Focus on clinical manifestations requiring intervention for adrenal insufficiency.
  • Focus on treatment for adrenal insufficiency.
  • Focus on patient education regarding the cause of symptoms for Cushing's syndrome and adrenal insufficiency.
  • Focus on steroid adverse effects/prophylactic medication to reduce effects.

Thyroid and Parathyroid Disorders

  • Focus on assessment findings that indicate additional care is needed.
  • Focus on post-op thyroidectomy observations to report immediately.
  • Focus on thyrotoxicosis priority actions.
  • Focus on treatment, standard and for complications.
  • Focus on hypoparathyroidism clinical manifestations and treatment.
  • Focus on hyperparathyroidism treatment.
  • Focus on myxedema clinical manifestations.

Diabetes Mellitus

  • Focus on patient preparation for HgbA1c.
  • Focus on selecting the most appropriate insulin syringe based on the order.
  • Focus on insulin administration, including patient teaching and return demonstration, proper technique, and safety considerations.
  • Focus on DKA assessment findings and treatment.
  • Focus on DM Type 2 macrovascular complications.
  • Focus on patient self-monitoring.

Pharmacology

  • Focus on indications, route, and mechanism of action for medications.
  • Focus on therapeutic effects and adverse effects of medications.
  • Focus on patient teaching for all listed medications.
  • Focus on prophylaxis medication (if indicated).
  • Patient safety is important

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