Endocrine Flashcards
A client is admitted to the critical care unit with a diagnosis of diabetic ketoacidosis. Following aggressive fluid resuscitation and intravenous (IV) insulin administration, the blood glucose begins to normalize. In addition to glucose monitoring, which of the following electrolytes requires close monitoring?
Potassium
Calcium
Sodium
Chloride
Potassium
A client is receiving hydrocortisone sodium succinate for adrenal crisis. What other medication does the nurse prepare to administer?
Regular insulin
Propranolol
A proton pump inhibitor
Canagliflozin
A PPI
In hyperosmolar hyperglycemic syndrome, the laboratory results are similar to those of diabetic ketoacidosis, with three major exceptions. What differences would the nurse expect to see in clients with hyperosmolar hyperglycemic syndrome?
Higher serum glucose, higher osmolality, and no ketosis
Lower serum glucose, lower osmolality, and greater ketosis
Higher serum glucose, higher osmolality, and greater ketosis
Lower serum glucose, lower osmolality, and milder ketosis
Higher serum glucose, higher osmolality, and no ketosis
A client presents to the emergency department with the following clinical signs: Pulse: 132 beats/min, Blood pressure: 88/50 mm Hg, Respiratory rate: 32 breaths/min, Temperature: 104.8°F, Chest x-ray: Findings consistent with congestive heart failure, Cardiac rhythm: Atrial fibrillation with rapid ventricular response. These signs are consistent with what disorder?
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
Myxedema coma
Adrenal crisis
Thyroid storm
Thyroid Storm
The nurse is caring for a client with a diagnosis of head trauma. The nurse notes that the client’s urine output has increased tremendously over the past 18 hours. The nurse suspects that the client may be developing:
Syndrome of inappropriate secretion of antidiuretic hormone
Hyperosmolar hyperglycemic syndrome
Diabetes insipidus
Diabetic ketoacidosis
DI
A nurse is caring for a client with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What laboratory values would the nurse expect to assess?
Serum sodium 115 mEq/L
Serum potassium 5.8 mEq/L
Fasting blood glucose 156 mg/dL
Serum calcium 9.2 mg/dL
Serum sodium 115 mEq/L
A college student was admitted to the emergency department after being found unconscious by a roommate. The roommate informs emergency medical personnel that the student has diabetes and has been experiencing flu-like symptoms, including vomiting, since yesterday. The client had been up all night studying for exams. The client used the last diabetes testing supplies 3 days ago and has not had time to go to the pharmacy to refill prescription supplies. Based upon the history, which laboratory findings would the nurse anticipate in this client (select all that apply)?
pH: 7.23
Blood glucose: 43 mg/dL
Blood glucose: 524 mg/dL
PaCO2: 37 mm Hg
HCO3: 10 mEq/L
pH: 7.23
Blood glucose: 524 mg/dL
HCO3: 10 mEq/L
A nurse at an outpatient office receives a call from a client with type I diabetes mellitus who is receiving a continuous subcutaneous insulin infusion via an insulin pump. The client reports mechanical failure of the infusion pump. The nurse instructs the client to begin monitoring for signs of ________________.
Adrenal insufficiency
Diabetic ketoacidosis
Hyperosmolar, hyperglycemic state
Hypoglycemia
DKA
A nurse is caring for a client who is newly diagnosed with type 1 diabetes mellitus and is being transitioned from an infusion of intravenous (IV) regular insulin to an intensive insulin therapy regimen of insulin glargine and insulin aspart (Novolog). How should the nurse manage this transition of insulin delivery?
Administer the insulin glargine and discontinue the IV infusion in several hours.
Discontinue the IV infusion and administer the insulin aspart with the next meal.
Administer the insulin glargine and continue the IV insulin infusion for 24 hours.
Discontinue the IV infusion and administer the Lantus insulin at bedtime.
Administer the insulin glargine and discontinue the IV infusion in several hours.
A client has been on daily, high-dose glucocorticoid therapy for the treatment of rheumatoid arthritis. His prescription runs out before his next appointment with his physician. Because he is asymptomatic, he thinks it is all right to withhold the medication for 3 days. What is likely to happen to this client?
He will go into adrenal crisis.
His autoimmune disease will go into remission.
He will go into thyroid storm.
Nothing; it is appropriate to stop the medication for 3 days.
He will go into adrenal crisis.
The nurse is caring for a client with head trauma who was admitted to the surgical intensive care unit following a motorcycle crash. What is an important assessment that will assist the nurse in early identification of an endocrine disorder commonly associated with this condition?
Urine osmolality
Fingerstick glucose
Lung sound auscultation
Daily weight
Urine osmolality
What is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
Fluid volume deficient
Activity intolerance
Impaired nutrition, more than body requirements
Hyperthermia
Fluid volume deficient
Which of the following would be seen in a client with myxedema crisis?
Decreased reflexes
Hyperthermia
Hyperventilation
Tachycardia
Decreased reflexes
The nurse is assigned to care for a client who presented to the emergency department with diabetic ketoacidosis. A continuous insulin intravenous infusion is started, and hourly bedside glucose monitoring is prescribed. The targeted blood glucose value after the first hour of therapy is:
A decrease of 200 mg/dL compared with admitting values.
less than 200 mg/dL.
a decrease of 50 to 75 mg/dL compared with admitting values.
90 to 120 mg/dL.
a decrease of 50 to 75 mg/dL compared with admitting values.
The nurse is caring for a client who underwent pituitary surgery 12 hours ago. The nurse will give priority to monitoring the client carefully for which of the following?
Infection
Congestive heart failure
Volume overload
Hypovolemic shock
Hypovolemic Shock
