Endocrine System

Question 1

What diagnostic test is used to determine thyroid activity?

Answer 1

T3, T4

Question 2

What condition results from all treatments for hyperthyroidism?

Answer 2

Hypothyroidism, requiring thyroid replacement

Question 3

State three symptoms of hyperthyroidism and three symptoms of hypothyroidism

Answer 3

Hyperthyroidism: weight loss, heat intolerance, diarrhea
Hypothyroidism: fatigue, cold intolerance, weight gain

Question 4

List five important teaching aspects for clients who are beginning corticosteroid therapy

Answer 4

Continue medication until weaning plan is begun by physician; monitor serum potassium, glucose, and sodium frequently, weight daily, and report gain of >5 lb/wk; monitor BP and pulse closely; teach symptoms of Cushing syndrome

Question 5

Describe the physical appearance of clients who have Cushing syndrome

Answer 5

Moon face, obesity in trunk, buffalo hump in back, muscle atrophy, and thin skin

Question 6

Which type of diabetes always requires insulin replacement?

Answer 6

Type 1

Question 7

Which type of diabetes sometimes requires no medication?

Answer 7

Type 2

Question 8

List five symptoms of hyperglycemia

Answer 8

Polydipsia, polyuria, polyphagia, weakness, weight loss

Question 9

List five symptoms of hypoglycemia

Answer 9

Hunger, lethargy, confusion, tremors or shakes, sweating

Question 10

Name the necessary elements to include in teaching a client newly diagnosed with diabetes

Answer 10

The underlying pathophysiology of the disease; its management and treatment regimen; meal planning; exercise program; insulin administration; sick-day management; symptoms of hyperglycemia (not enough insulin); symptoms of hypoglycemia (too much insulin, too much exercise, not enough food); foot care

Question 11

In fewer than 10 steps, describe the method of drawing up a mixed dose of insulin (regular with NPH)

Answer 11

Identify the prescribed dose and type of insulin per physician order; store unopened insulin in refrigerator. Opened insulin vials may be kept at room temperature. Draw up regular insulin first; rotate injection sites; may reuse syringe by recapping and storing in refrigerator

Question 12

Identify the peak action time of the following types of insulin: rapid-acting regular insulin; intermediate-acting insulin; long-acting insulin

Answer 12

Rapid-acting regular insulin: 2 to 4 hours
Immediate-acting insulin: 6 to 12 hours
Long-acting insulin: 14 to 20 hours

Question 13

When preparing a client with diabetes for discharge, the nurse teaches the client the relationship between stress, exercise, bedtime snacking, and glucose balance. State the relationships among each of these

Answer 13

Stress and stress hormones usually increase glucose production and increase insulin need. Conversely, exercise may increase the chance of an hypoglycemic reaction; therefore, the client should always carry a fast-acting source of carbohydrate, such as glucose tablets or hard candies, when exercising

Question 14

When making rounds at night, the nurse notes that a client prescribed insulin is complaining of a headache, slight nausea, and minimal trembling. The client’s hand is cool and moist. What is the client most likely experiencing?

Answer 14

Hypoglycemia / insulin reaction

Question 15

Identify five foot-care interventions that should be taught to a client with diabetes

Answer 15

Check feet daily, and report any breaks, sores, or blisters to health care provider; wear well-fitting shoes; never go barefoot or wear sandals; never personally remove corns or calluses; cut or file nails straight across; wash feet daily with mild soap and warm water