BN Ch.79 Endocrine Disorders

Question 1

The condition of breaking down of fat tissue with scarring and malabsorption is called _________.

Answer 1

lipodystrophy

Question 2

Diabetes that develops spontaneously or
without an identifiable cause is called __________ diabetes.

Answer 2

idiopathic

Question 3

The condition of excessive hunger is called __________.

Answer 3

polyphagia

Question 4

Hypoglycemia is caused by an excess of __________ hormone.

Answer 4

insulin

Question 5

Surgical removal of the pituitary gland is called __________.

Answer 5

hypophysectomy

Question 6

Cortisol

Answer 6

Cushing Syndrome

Question 7

Thyroxine

Answer 7

Graves Disease

Question 8

Antidiuretic Hormone

Answer 8

Diabetes insipidus

Question 9

Insulin

Answer 9

Diabetes mellitus

Question 10

Write the correct sequence involved in testing
blood glucose levels in a client with diabetes.
1. Put on sterile disposable gloves.
2. Gently massage and keep finger in dependent position.
3. Clean the puncture site with alcohol.
4. Prepare the lancet by twisting off the cap.

Answer 10

4. Prepare the lancet by twisting off the cap.
5. Put on sterile disposable gloves.
6. Gently massage and keep finger in dependent position.
7. Clean the puncture site with alcohol.

Question 11

What are the signs and symptoms of diabetes mellitus?

Answer 11

• The major symptoms of diabetes mellitus are excessive urination (polyuria), excessive thirst (polydipsia), and excessive hunger (polyphagia).
• These classic symptoms are found more often in type 1 than in type 2 diabetes.
• Other symptoms include fatigue, blurred vision, mood changes, numbness and tingling in extremities, dry skin, urinary tract and vaginal yeast infections, and weight loss (most often in type 1).

Question 12

What are the signs and symptoms of hypoparathyroidism?

Answer 12

• Hypoparathyroidism is characterized by tremors and tetany caused by decrease in blood calcium levels.
• The client with this disorder may have decreased cardiac output.
• Trousseau sign (carpopedal spasm caused by blocking the blood flow to the arm for 3 minutes using a blood pressure cuff) and Chvostek sign (twitching of the mouth, nose, and eye after tapping the area over the facial nerve just in front of the parotid gland and anterior to the ear), when positive, suggest latent tetany.
• Other common symptoms include hair loss, skin coarsening, brittle nails, arrhythmias, and possible heart failure.

Question 13

What are the laboratory tests that are conducted to evaluate the function of the parathyroid gland?

Answer 13

• Blood tests conducted to evaluate parathyroid function include serum parathormone levels, serum phosphate and calcium levels, urinary calcium, and serum alkaline phosphatase.
• Tests of other systems also help in the evaluation, because normal calcium and phosphorus balance involves multiple body systems, including the musculoskeletal, gastrointestinal, and urinary systems.
• Ultrasound, magnetic resonance imaging (MRI), thallium scan, and fine-needle biopsy are other tests that help to evaluate the function of the parathyroid glands

Question 14

What are the complications associated with angiogram or venogram tests used to evaluate adrenal function?

Answer 14

• Angiogram or venogram examinations help to detect benign and malignant tumors of the adrenal glands, as well as hyperplasia.
• The procedure for both of these tests involves the insertion of a catheter, followed by injection of a contrast dye so that radiographic contrast studies of the adrenals can be done.
• The major complications of these tests are allergic reactions to the dye.
• Therefore, it is important to determine the client’s allergy to dye before the test.
• Another complication associated with the test is the chance of hemorrhage or dislodging of an atherosclerotic plaque from the wall of the blood vessel used for dye injection.
• This can cause an infarction in the client.
• If the hemorrhage occurs within the adrenal glands, there is a possibility that the client may be affected with Addison disease.
• Angiograms and venograms are also contraindicated in pregnant, unstable, or uncooperative clients and in those with hemophilia or atherosclerosis.

Question 15

What are the classes of diabetes mellitus?

Answer 15

• Type 1 (insulin-dependent diabetes mellitus [IDDM] or juvenile diabetes)
• Type 2 (non–insulin-dependent diabetes mellitus [NIDDM] or adult-onset diabetes)
• Gestational diabetes mellitus (GDM), which occurs during pregnancy and disappears after delivery
• Impaired glucose metabolism (or impaired glucose homeostasis [IGH]), which includes two different subclasses—impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)
• Immune-mediated diabetes

Diabetes may also be caused by genetic defects in pancreatic beta-cell function or insulin action, diseases of the exocrine pancreas, endocrinopathies (either drug or chemical induced), infections, and other genetic syndromes.

Question 16

A nurse’s role in managing endocrine disorders involves monitoring the symptoms of the disorder and providing proper nursing care. The nurse also helps clients with activities of daily living (ADLS).
1. A 30-year-old client with hypothyroidism is admitted to the healthcare facility.
a. Which data should the nurse collect from
clients with endocrine disorders?

Answer 16

The nurse should collect the following data from clients with endocrine disorders:

• Conduct a physical examination and document the client’s status for possible endocrine disorders.
• Check and document the results of various laboratory tests.
• Monitor and document the signs and symptoms of endocrine disorders.
• Observe and document the client’s emotional response to the disorder or disease.
• Collect data related to the client’s daily needs and document whether the client needs assistance to meet them.

Question 17

What are the nursing considerations employed when caring for a client with hypothyroidism?

Answer 17

• Nursing care for a client with hypothyroidism should focus mainly on the client’s improvements in activity tolerance and independence, resuming normal bowel function, improving mental activity, and adhering to the medical regimen.
• The nurse should instruct the client about the importance of periodic examinations.
• The nurse should avoid the administration of sedatives, narcotics, and hypnotic drugs to the client with hypothyroidism, because these medications can cause respiratory or cardiac arrest.
• The nurse should immediately report any signs of myocardial infarction or anginal pain.
• The nurse should teach the client to recognize the signs and symptoms of angina.

Question 18

A 55-year-old client with diabetes was
brought to a healthcare facility with
complaints of weakness and sudden exhaus-
tion. They experienced dizziness, confusion,
and excessive sweating. They were diagnosed
as having a hypoglycemic attack.
a. Which information should the nurse
provide to the client to help them control
their hypoglycemic condition?

Answer 18

The nurse should provide the following information to the client to control his hypoglycemic condition:

• Inform the client about the symptoms of hypoglycemia, and how to identify and manage them.
• Encourage frequent monitoring of blood glucose levels.
• Instruct the client to have a sugar supply readily available at all times.
• Instruct the client to avoid the use of chocolate bars as treatment for a hypoglycemic reaction, because the high-fat content prevents quick release of glucose.
• Encourage the client to carry a simple carbohydrate snack.
• Teach the client how to use glucagon or a glucose emergency kit.
• Encourage the client to wear a medical alert identification bracelet or tag.

Question 19

What are the foot care measures that
should be employed when caring for a
client with diabetes?

Answer 19

The following are the foot care measures to be employed when caring for diabetic clients:

• Inspect and wash the client’s feet daily.
• Dry the feet thoroughly, especially between toes.
• Massage the feet gently with a good-quality lotion, but avoid using lotion between the toes.
• Cut the nails straight across with blunt-tipped scissors, with healthcare provider’s permission.
• Instruct the client to see a podiatrist for treatment of corns, calluses, or ingrown toenails.
• Do not allow the client to walk barefoot.
• Put lambswool between overlapping toes.
• Instruct the client to exercise daily.
• Instruct the client to wear high-quality shoes, which provide better support.
• Instruct the client to see the healthcare provider if there are any cuts or burns on the foot.
• Use warm socks and extra blankets for cold toes.
• Avoid using constrictive stockings or adhesive tape on the client’s feet.