Lewis Chapter 51 Elsevier Flashcards
The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for which of the following manifestations?
A. Neurological irritability
B. Declining urine output
C. Fatigue and weakness
D. Hyperactive bowel sounds
C. Hyperparathyroidism can cause hypercalcemia. Signs of hypercalcemia include polyuria, constipation, nausea and vomiting, fatigue, and muscle weakness.
The nurse should monitor for which of the following adverse changes in the patient’s laboratory values as a result of being treated with dexamethasone?
A. Sodium 130 mmol/L
B. Calcium 2.05 mmol/L
C. Potassium 4.9 mmol/L
D. Blood glucose 8.9 mmol/L
D. Hyperglycemia or increased blood glucose level is an adverse effect of corticosteroid therapy.
The nurse is providing discharge teaching to a patient with diabetes insipidus who is taking desmopressin acetate (DDAVP) intranasally. Which of the following instructions should the nurse include in the patient teaching plan?
A. Weight loss resulting from increased diuresis
B. Alternate nostrils during administration
C. Monitor for symptoms of hypernatremia
D. Report any decrease in urinary elimination to the health care provider
B. Desmopressin acetate (DDAVP) is used to treat diabetes insipidus by replacing the antidiuretic hormone that the patient is lacking. DDAVP can cause nasal irritation, headache, nausea, and other signs of hyponatremia. To reduce the occurrence of nasal irritation, the patient should be taught to alternate nostrils during administration.
The patient has a prescription for prednisone 45 mg PO daily. Available are 10 mg tablets. How many tablets should the nurse prepare to give?
A. 1.6
B. 2
C. 4.5
D. 6
C. 45 mg ÷ 10 mg = 4.5 tablets
Which of the following is a nursing priority in the care of a patient diagnosed with hypothyroidism?
A. Providing a dark, low-stimulation environment
B. Closely monitoring the patient’s intake and output
C. Patient teaching related to levothyroxine
D. Patient teaching related to radioactive iodine therapy
C. A euthyroid state is most often achieved in patients with hypothyroidism by the administration of levothyroxine (Synthroid, Eltroxin). It is not necessary to carefully monitor intake and output, and low stimulation and radioactive iodine therapy are indicated in the treatment of hyperthyroidism.
A patient has been taking oral prednisone for the past several weeks after having a severe reaction to poison ivy. The nurse has explained the procedure for gradual reduction rather than sudden cessation of the drug. What of the following complications does this approach to drug administration prevent?
A. Hypothyroidism
B. Diabetes insipidus
C. Adrenal insufficiency
D. Cardiovascular complications
C. Sudden cessation of corticosteroid therapy can precipitate life-threatening adrenal insufficiency. Diabetes insipidus, hypothyroidism, and cardiovascular complications are not common consequences of stopping corticosteroid therapy suddenly.
The nurse is caring for a patient who had a thyroidectomy, which included the removal of the parathyroid gland. Which of the following assessments should the nurse prioritize when providing postoperative care for this patient?
A. Assessing the patient’s white blood cell levels and assessing for infection.
B. Monitoring the patient’s hemoglobin, hematocrit, and red blood cell levels.
C. Monitoring the patient’s serum calcium levels and assessing for signs of hypocalcemia.
D. Monitoring the patient’s level of consciousness and assessing for acute delirium or agitation.
C. Loss of the parathyroid gland is associated with hypocalcemia. Infection and anemia are not associated with loss of the parathyroid gland, whereas cognitive changes are less pronounced than the signs and symptoms of hypocalcemia.
