Metabolism Flashcards
A patient is diagnosed with hyperglycemia. For which electrolyte imbalance should the nurse closely monitor?
A. Hyperglycemia
B. Hypermagnesemia
C. Hyperkalemia
D. Hypernatremia
D. Hypernatremia
Rationale: the patient with hyperglycemia is at risk for hypernatremia. Hyperglycemia causes polyuria in the patient with diabetes resulting in dehydration. Hypernatremia is a laboratory finding for a patient with dehydration. Hyperkalemia, hypercalcemia, and hypermagnesemia are not associated with hyperglycemia.
Assessment for hypernatremia includes:
- monitoring intake and output
- monitoring level of consciousness
- encouraging oral intake
- providing mouth care
- monitoring sodium intake
- monitoring vital signs
- monitoring laboratory findings
- monitoring skin and mucous membranes for signs of dehydration
The nurse is teaching a patient about the supplemental thyroid hormone (TH) prescribed by the healthcare provider.
Which patient statement requires further teaching?
A. “If I do not take the hormone, I can experience weight gain.”
B. “I can experience life-threatening problems if I do not take this hormone.”
C. “If I continue to experience dry skin, I’ll call my healthcare provider.”
D. “I will need to take the thyroid hormone until my fatigue is better.”
D. “I will need to take the thyroid hormone until my fatigue is better.”
Rationale: If a patient does not take thyroid hormone as prescribed, they can experience fatigue, dry skin, and weight gain. Patients cannot stop taking the hormone once they feel better or the symptoms will return. Long-term, severe hypothyroidism can result in myxedema, a condition in which mucopolysaccharides are deposited in the dermis. Severe hypothyroidism with other insults (for example, infection) can lead to myxedema coma, in which the individual experiences an altered mental state leading to coma, and can be life-threatening because it causes generalized swelling throughout the body. Weight gain will result if the patient stops taking thyroid hormone. The primary role of thyroid hormone in adults is to increase metabolism. Dry skin may be an indication the thyroid hormone dose needs to be adjusted; the patient should see their healthcare provider.
The nurse can promote health in patients with metabolic or endocrine disorders by performing the following activities:
Routinely monitoring affected hormone levels.
Monitoring fluid and electrolyte levels.
Testing for related secondary disorders.
Reminding the patient to report worsening or additional signs and symptoms.
Providing information on appropriate nutritional support for the condition.
Encouraging the patient to maintain a healthy weight and exercise routine.
A patient prescribed a bisphosphonate asks the nurse, “How does this medication help my osteoporosis?”
Which statement provides the patient with an accurate response?
A. “The medication will bind with the calcium in your diet and transfer it into the bones.”
B. “The medication will stop the loss of calcium from your bones.”
C. “The medication will reduce the risk of fractures.”
D. “The medication will increase the absorption of calcium in your bones.”
C. “The medication will reduce the risk of fractures.”
Rationale:
Bisphosphonates are potent inhibitors of bone resorption that may be used to prevent and treat osteoporosis. They inhibit bone breakdown, preserve bone mass, and increase bone density in the hip and vertebrae. Bisphosphonates do not bind with calcium and transport it into the bones, increase the absorption of calcium, or inhibit the loss of calcium from the bones.
An older adult patient is experiencing alterations in sensory and cognitive functioning.
Which interview question should the nurse ask to determine the patient’s sensory and cognitive functioning?
A. “Have you noticed any tremors in your hands?”
B. “Have you had any heart palpitations?”
C. “Have you noticed any difficulty swallowing?”
D. “Have you had any difficulty urinating?”
“Have you had any heart palpitations?”
rationale:
Interview questions that focus on sensory and cognitive functioning include asking about being restless, anxious, or confused, and heart palpitations. Hand tremors, difficulty with swallowing, and urinating are not related to sensory and cognitive functioning.
Major areas of concern for a health history for endocrine disorders include the following:
History
Nutrition and metabolism
Cognitive and sensory perception
Stress and coping
The nurse is caring for a patient with diabetes who is experiencing dehydration and tachycardia.
Which assessment should the nurse implement to ensure that the patient has adequate oxygenation?
A. Monitoring vital signs
B. Monitoring the patient for edema
C. Monitoring neurologic functioning
D. Monitoring intake and output
Monitoring neurologic functioning
Rationale
Early neurologic changes are subtle and important to recognize that they may be caused by inadequate oxygenation and perfusion. Anxiety and restlessness are important to note. Monitoring vital signs such as pulse oximetry may take longer to indicate inadequate perfusion. Intake and output reflect the cardiovascular status and renal function. Edema is a reflection of fluid status and cardiovascular functioning.
Monitoring oxygenation with a metabolic disorder includes:
- -> Closely monitoring patients with alterations in metabolism for changes in perfusion.
- -> Closely monitoring heart rate and blood pressure because changes to these vital signs are often early signs of problems.
- -> Monitoring intake and output, water and electrolyte levels, and edema, as they can radically alter blood volume and heart workload.
An older adult patient states, “My skin always seems to look so pale.”
Which response by the nurse is accurate?
A. “Your skin becomes more vascular as you age.”
B. “As you age, your body produces less melanin.”
C. “Your diet may need to be modified to prevent this change.”
D. “It may be an indication that you are developing Addison disease.”
“As you age, your body produces less melanin.”
rationale
The skin of older adults becomes pale due to decreased melanin, a pigment produced by melanocyte-stimulating hormone that increases skin pigmentation. Older adults also have decreased dermal vascularity, which also causes a paleness of the skin. Hyperpigmentation is usually seen in Addison disease, not pale skin.
Skin assessment for patients with endocrine disorders includes:
Inspecting the skin color.
Palpating the skin.
Assessing texture and moisture.
Inspecting for the presence of lesions.
The nurse is caring for a patient newly diagnosed with type 2 diabetes mellitus.
Which patient statement reflects a subjective finding of type 2 diabetes?
A. “I am constantly thirsty and cannot get enough to drink.”
B. “I have so much energy that I cannot sleep at night.”
C. “I have completely lost my appetite, but I am gaining weight.”
D. “I am having difficulty urinating.”
“I am constantly thirsty and cannot get enough to drink.”
rationale
Alterations in glucose regulation are related to changes in insulin secretion, regulation, and response alters the body’s ability to control the blood glucose. A patient with type 2 diabetes may present with an objective symptom of polydipsia (excessive thirst). Polyphagia and polyuria are common symptoms that may also be present in the patient. Excessive energy, difficulty sleeping, and difficulty urinating are not symptoms associated with type 2 diabetes mellitus.
The nurse is preparing to instruct a patient on the newly prescribed antithyroid medication.
Which information should be included for the prescribed medication?
A. Count radial pulse rate for 1 minute before taking the medication.
B. Avoid taking aspirin with this medication.
C. Take the medication at the same time every day.
D. Take the medication 1 hour before meals.
Take the medication at the same time every day.
Antithyroid medication is a class of drugs used to treat hyperthyroidism. The medication should be taken at the same time every day to ensure a consistent blood level. Medications for hypothyroidism should be taken 1 hour before meals. Medications for hypothyroidism can potentiate the effects of anticoagulants such as aspirin. The pulse should be assessed before taking a medication for hypothyroidism.
Patient teaching for methimazole treatment includes:
- -> Diluting liquid iodine sources in water or orange juice to disguise bitter taste.
- -> Monitoring for increased bleeding, bruising, and petechiae.
- -> Taking medications at the same time each day with meals to maintain stable blood levels.
The nurse is caring for a patient diagnosed with hypothalamic dysfunction. Tumors have been confirmed as a possible contributing factor to the disease.
The nurse should anticipate preparing the patient for which collaborative treatment?
A. Antithyroid agent
B. Thyroid agent
C. Biopsy of the tumor
D. Surgery
Surgery
Treatment of hypothalamic disease depends on the cause of the hypothalamic dysfunction. Tumors are treated with surgery or radiation. An antithyroid agent, biopsy, or a thyroid agent is not used for the treatment of hypothalamic dysfunction.
