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NCLEX: Prioritization, Delegation, And Assignment 5th Edition > Endocrine Others > Flashcards

Endocrine Others Flashcards

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1
Q

25 extra strong thirst, dilute, excessive straw colored urine upto 15L/ day. Most likely

  1. Type 2 DM
  2. DI
  3. Cushings
  4. Addison
A

DI

Post pituitary gland disorder
Water loss due to ADH lack or kidneys don’t respond to it.

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2
Q

Possible Graves disease (Hyperthyroidism)

  1. Periorbital edema
  2. Bradycardia
  3. Exophthalmos
  4. Hoarse voice
A
  1. Exophthalmos

Other = Hypothyroidism
1. Periorbital edema
2. Bradycardia
4. Hoarse voice

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3
Q

Hyperthyroidism
What VS would a nurse instruct UAP to report immediately

A

Rapid HR. BP problems can come quickly because of this

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4
Q

Cushings. All of the following are found which is most important to notify HCP immediately

  1. Purple striae present on abdomen and thighs
  2. 1 lb weight gain since previous day
  3. Dependent crackles in lower lobe of lungs
  4. Dependent edema rated +1 in ankles and calves
A
  1. Dependent crackles in lower lobe of lungs

Excess sodium & fluid volume causes fluid in lungs & crackles. May be pulmonary edema rapid treatment needed.

Striae (Stretch marks), weight gain, and dependent edema are common findings in Cushings.

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5
Q

Pheochromocytoma

Palpatine the abdomen in 4 quadrant is not advised. Why?

What is pheochromocytoma

A

pheochromocytoma = usually beginen tumor on adrenal glands cause more catacholomones to be released.

Tapping my break tumor

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6
Q

Adrenal hypo function Describe

____ tension
____ natremia
____ kalemia
____ glycemia

A

Hypertension
Hyponatremia
Hyperkalemia
Hyperglycemia

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7
Q

Adrenal insufficiency discharged with prednisone 10mg. Which instruction would nurse be sure to teach

  1. Excessive weight gain or swelling should be reported to HCP
  2. Changing posistions may cause dizziness
  3. Diet food with low sodium may be beneficial to prevent side effects
  4. Signs of hypoglycemia may occur when taking this medicine.
A
  1. Excessive weight gain or swelling should be reported to HCP

This means dose is too high

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8
Q

Postop hypophysectomy (Removal of the pituitary gland “master gland”)
For hyperpituitarism. Which post opp finding requires immediate intervention

  1. Presence of glucose in nasal drainage
  2. Presence of nasal packing in the nares
  3. Urine output 40 / 50 mL
  4. Patient reports thirst
A
  1. Presence of glucose in nasal drainage

Suggest CSF is leaking from the brain.

Packing is normal in nares

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9
Q

Which patient to give LPN under supervision of RN

  1. 51 just undergone bilateral adrenalectomy
  2. 83 type 2 DM & chronic COPD
  3. 38 myocardial infarction preparing for discharge
  4. 72 mental status change admitted from LTC
A

83 has no complaining factors

RN should assess postop patients
RN for newly admitted
RN for discharge

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10
Q

24 DI makes all the following statements. Which requires further teaching

  1. I will drink fluids = to amount of urine
  2. Weight self everyday using same scale
  3. Will wear my medical alert bracelet
  4. Gradually wean self off vasopressin
A
  1. Gradually wean self off vasopressin

DI requires vasopressin for life, brother

Vasopressin also known as antidiuretic hormone (ADH),helps the body’s fluid balance by signaling the kidneys to retain water.

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11
Q

Fresh postop hypophysectomy (Pituitary gland removal) which is Contradicted.

  1. Assess for changes in vision or mental status
  2. Keep HOB elevated
  3. Remind patient deep breathing exercises every hours
  4. Encourage patient to cough vigorously
A
  1. Encourage patient to cough vigorously
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12
Q

Which would be seen in Cushings SATA

  1. Increased serum calcium
  2. Increased salivary cortisol
  3. Increased urinary cortisol
  4. Decreased serum glucose
  5. Decreased sodium
  6. Increased serum cortisol
A
  1. Increased salivary cortisol
  2. Increased urinary cortisol
  3. Increased serum cortisol

With Cushings also

+ BS
+ Sodium

  • lymphocytes
  • serum calcium
  • potassium
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13
Q

Addiaon disease nurse should be alert for which lab value

  1. Decreased hematocrit
  2. Increased sodium
  3. Decreased K
  4. Decreased calcium
A
  1. Decreased hematocrit

Addisons BOLO for anemia

Nurse should expect low sodium & high K & Calcium

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14
Q

Female primary hypofunction of adrenal glands. Which nursing assessment finding supports this

  1. Patchy areas of pigment loss over the face
  2. Decreased muscle strength
  3. Greatly increased urine output
  4. Scalp alopecia
A
  1. Patchy areas of pigment loss over the face

Vitiligo happens with hypofunction of adrenal glands and is caused by autoimmune destruction of melanocytes.

Pituitary hypofunction
Decreased muscle strength
Greatly increased urine output
Scalp alopecia

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15
Q

Why should the thyroid gland be palpated gently?

Correct body placement

What do you ask the patient to do to help find the thyroid gland

A

Thyroid Storm is possible in patients who have Hyperthyroidism.

Behind or in front with both hands

Swallowing helps find the thyroid gland

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16
Q

Two UAP are assisting patient with Cushings disease to move up in bed. Which action requires immediate intervention

  1. Positioning themselves on opposite sides of the bed
  2. Grasping under patients arms to pull him up in bed
  3. Lowering the side rails before moving
  4. Removing pillows before moving
A

Grasping under patients arms to pull him up in bed

Cushings patients have paper thin skin

Use lift or drawsheet

Other actions are appropriate

17
Q

Why would it be common to see bruises and petechiae on a patient with Cushings disease?

A

They have fragile capillaries

18
Q

Which is to be reported immediately after a partial Thyroidectomy

  1. Temp 100.2
  2. HR increase from 64 - 76
  3. RR 26 - 16
  4. Pulse Ox 92%
A

Temp 100.2

A temp increase of 1 degree must be reported due to risk for Serious Complication Thyroid Crisis

19
Q

After thyroid surgery the first priority is to monitor for symptoms of airway obstruction. (Stridor, dyspnea, falling oxygen levels, inability to swallow, drooling)

What can happen due to the thyroid surgery to cause this to happen

A
  1. Hematoma formation from bleeding within the first 24 hours
  2. Hypocalcemia
    In rare cases, severe hypocalcemia can cause airway obstruction 24–72 hours after surgery.
  3. Pneumocoele
    A pneumocoele that gradually increases in size can cause airway obstruction, possibly due to secondary laryngeal edema.
  4. Thyroid enlargement
    In some cases, the bilateral thyroid glands can enlarge and significantly narrow the tracheal lumen.
20
Q

Which order for DI would you question

  1. Is & Os
  2. Check urine specific gravity
  3. Restrict fluids 6 hrs
  4. Weigh patient every morning
A
  1. Restrict fluids 6 hrs

Don’t ever restrict fluids on DI

Other interventions are appropriate

NCLEX: Prioritization, Delegation, And Assignment 5th Edition (26 decks)

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