Medsurg final 4

Question 1

Addison’s disease

Answer 1

an adrenocortical insufficiency

Question 2

Addison’s disease is caused by

Answer 2

damage or dysfunction of the adrenal cortex

Question 3

With Addison’s disease, the production of _____ and _____ is diminished

Answer 3

mineralocorticoids and glucocorticoids

Question 4

With Addison’s disease, the production of mineralocorticoids and glucocorticoids is diminished, resulting in decreased

Answer 4

aldosterone and cortisol

Question 5

a life-treating event that left untreated can lead to death

Answer 5

Acute adrenal insufficiency

Question 6

Sepsis 
Trauma 
Stress (myocardial infarction, surgery, anesthesia, hypothermia, volume loss, hypoglycemia) 
Adrenal hemorrhage 
Steroid withdrawal

Can precipitate

Answer 6

Acute adrenal insufficiency

Question 7

Addison’s: manifestations: Craving for

Answer 7

salt

Question 8

Addison’s: manifestations: Weight

Answer 8

loss

Question 9

Addison’s: manifestations: Hyper_______

Answer 9

hyperpigmentation

Question 10

Addison’s: manifestations: Severe

Answer 10

hypotension (acute adrenal insufficiency)

Question 11

ACTH is infused, and the cortisol response is measured 30 min and 1 hr after the injection. With primary adrenal insufficiency, plasma cortisol levels do not rise.

Answer 11

Adrenocorticotropic hormone (ACTH) stimulation test

Question 12

Adrenocorticotropic hormone (ACTH) stimulation test: ACTH is infused, and the cortisol response is measured 30 min and 1 hr after the injection. With primary adrenal insufficiency,

Answer 12

plasma cortisol levels do not rise.

Question 13

Addison’s tx: Monitor the client for

Answer 13

fluid deficits and electrolyte imbalances

Question 14

Addison’s tx: if the client has fluid deficits

Answer 14

Administer saline infusions to restore fluid volume

Question 15

Addison’s tx: Administer ____ IV bolus and a continuous infusion or intermittent IV bolus

Answer 15

hydrocortisone

Question 16

Addison’s: electrolyte you’re worried about

Answer 16

hyperkalemia

Question 17

Addison’s: Monitor for and treat ____glycemia

Answer 17

hypoglycemia

Question 18

Addison’s: Administer food and/or supplemental _____.

Answer 18

glucose

Question 19

Addison’s: _____ is used as an adrenocorticoid replacement for adrenal insufficiency and as an anti-inflammatory

Answer 19

Glucocorticoid

Question 20

Addison’s: Glucocorticoid is used as an adrenocorticoid replacement for adrenal insufficiency and as an

Answer 20

anti-inflammatory

Question 21

Addison’s: hydrocortisone: Increase dosage during periods of

Answer 21

stress or illness if necessary.

Question 22

Addison’s tx: Report symptoms of Cushing’s syndrome

Answer 22

(round face, edema, weight gain)

Question 23

Addison’s: discharge teaching: Avoid using ____ and ____

Answer 23

alcohol and caffeine

Question 24

Addison’s: discharge teaching: monitor for ____glycemia

Answer 24

hypoglycemia

Question 25

fever, fatigue, muscle weakness, dizziness, anorexia are symptoms of

Answer 25

adrenal insufficiency

Question 26

To prevent acute adrenal insufficiency, instruct clients who have Addison’s disease to

Answer 26

increase corticosteroid doses as directed by a provider during times of stress.

Question 27

Acute adrenal insufficiency (Addisonian crisis) occurs when there is an acute drop in adrenocorticoids due to sudden __________ or when induced by severe trauma, infection, or stress

Answer 27

discontinuation of glucocorticoid medications

Question 28

Acute adrenal insufficiency (Addisonian crisis) occurs when there is an acute drop in adrenocorticoids due to sudden discontinuation of glucocorticoid medications or when induced by

Answer 28

severe trauma, infection, or stress

Question 29

Acute adrenal insufficiency (Addisonian crisis): Administer ____ to move potassium into cell

Answer 29

Administer insulin to move potassium into cell. Glucose often is given with insulin.

Question 30

Acute adrenal insufficiency (Addisonian crisis): Administer ____ to counteract the effects of hyperkalemia and protect the heart

Answer 30

calcium

Question 31

Acute adrenal insufficiency (Addisonian crisis): Establish an IV line and initiate a rapid infusion of

Answer 31

NS

Question 32

Insufficient glucocorticoid causes increased insulin sensitivity and decreased glycogen, which leads to

Answer 32

hypoglycemia

Question 33

hypoglycemia: Instruct the client to have a __ __ ______ snack readily available

Answer 33

15 g carbohydrate

Question 34

Decrease in ______ levels can cause an increased excretion of sodium and a decreased excretion of potassium.

Answer 34

aldosterone