Chapter 39: Endocrine

A patient scheduled for diagnostic tests for hypothyroidism. Which symptoms should the nurse expect to observe in a patient with this disorder?
Click the card to flip 👆
1 / 45
Terms in this set (45)
A patient scheduled for diagnostic tests for hypothyroidism. Which symptoms should the nurse expect to observe in a patient with this disorder?
Dry skin and slowed heart rate
A patient is prescribed levothyroxine (Synthroid) for hypothyroidism. Which statement should the nurse include when teaching the patient about this medication?
"Worsening hypothyroidism can result in a condition called myxedema coma, so it is important to take this medication."
The nurse is caring for a patient with a history of asthma who is newly diagnosed with hyperthyroidism. What assessment finding should the licensed practical nurse (LPN) report immediately to the registered nurse (RN)?
Heart rate 112 beats/min
The nurse is caring for a patient with exophthalmos secondary to Graves disease. What nursing interventions are appropriate for this patient?
Reassurance that the symptoms will resolve when the Graves disease is under control
The nurse is preparing a patient for a thyroidectomy to treat hyperthyroidism. What patient statement indicates to the nurse that the patient understands the preoperative instructions?
I will probably need thyroid replacement medication after surgery.
A patient recovering from a thyroidectomy is being assessed for tetany. What is the most likely cause of tetany after this surgery?
Excess circulating thyroid hormone released during manipulation of the gland during surgery
A patient who is one day postoperative thyroidectomy reports feeling numb around the mouth and is experiencing random muscle twitches. Which intravenous (IV) medication should the nurse anticipate that the physician will prescribe?
calcium gluconate
The nurse is caring for a patient following a thyroidectomy. Which postoperative assessment activity is most important to detect the development of thyrotoxic crisis?
Monitor vital signs
A patient 6 hours after a thyroidectomy has a temperature of 104F, pulse 144 beats per minute, respirations 24 per minute, and blood pressure 184/108 mm Hg. Which orders should the nurse anticipate being prescribed for this patient?
Beta blockers and a cooling blanket
The nurse is caring for a patient following a thyroidectomy. What item is most important to have at the bedside?
Tracheostomy set
A nurse is approached by a neighbor who has a neck growth that appears to be a goiter. What should the nurse do?Question the neighbor about symptoms of hypothyroidism or hyperthyroidism.While doing volunteer health screenings at a local mall a patient with a large growth on the neck approaches the nurse. What finding should alert the nurse to send the patient to the physician immediately?The patient makes a funny high-pitched sound with each breath.A patient develops hyperparathyroidism related to a benign tumor. What laboratory result should the nurse expect to see?elevated serum calciumA patient with hyperparathyroidism asks why ambulation three times per day is necessary because it is so difficult to do so. Which response by the nurse is best?"Walking will keep the calcium where it belongs—in your bones."The nurse is caring for a patient who is newly diagnosed with acromegaly. Which treatment does the nurse anticipate?Irradiation of the thyroid glandA patient is newly diagnosed with acromegaly. Which nursing diagnosis should the nurse identify as being appropriate for this patient?body image disturbanceThe nurse is planning care for a patient with diabetes insipidus. What data should the nurse to monitor this patient?Intake, output, and daily weightA patient is newly diagnosed with diabetes insipidus. Which medications should the nurse anticipate being prescribed for long-term patient management?desmopressin acetateThe nurse determines that treatment has been effective for a patient with diabetes insipidus. Which laboratory value did the nurse use to come to this conclusion?urine specific gravityThe nurse is caring for a patient with lung cancer who develops syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Which assessment findings should the nurse expect?Weight gain and concentrated urineAfter collecting data the nurse determines that a patient is at risk for compression fractures. What health problem caused the nurse to come to this conclusion?HyperparathyroidismA patient with chronic obstructive pulmonary disease prescribed corticosteroid therapy asks what the medication does. What should the nurse respond to the patient?It is an anti-inflammatory agent that reduces the swelling in your airways.A patient with chronic obstructive pulmonary disease develops Cushings syndrome related to long- term steroid use. The physician writes an order to discontinue the steroids. Which action by the nurse is most appropriate?question the orderThe nurse develops a nursing diagnosis of fluid volume excess related to sodium retention secondary to steroid therapy as evidenced by weight gain of 12 pounds in 2 weeks and edema of lower extremities. Which goal is most appropriate?Patient will have improved fluid balance as evidenced by weight returning to baseline.A patient is demonstrating manifestations of a pheochromocytoma. Which intervention is the most important for the nurse to implement?Provide a calm, quiet environment.A patient enters the emergency department in adrenal crisis. The patient is lethargic and vital signs are blood pressure 85/52 mm Hg and pulse 88 beats/min. Which event in the patients week most likely precipitated this crisis?Being laid off from a jobThe nurse is assisting with discharge of a patient with Addisons disease following an adrenal crisis. Which instruction is most important for the nurse to reinforce?The importance of taking steroid replacements as prescribedLPN is caring for a patient with diabetes insipidus and obtains a urine specific gravity reading of 1.002. Which response by the LPN is most important?Report the reading to the RN because therapy is ineffective.A patient with an adrenal disorder is prescribed fludrocortisone. What is important for the nurse to monitor in this patient?serum potassium levelsA patient is diagnosed with hyperthyroidism. What should the nurse realize as being the most common cause of this disorder?Graves diseaseThe nurse is reviewing discharge instructions with a patient recovering from a hypophysectomy. What should the nurse emphasize with this teaching?Be sure to take the thyroid hormone, corticosteroids, and sex hormones that have been prescribed for you.The nurse is caring for a patient with diabetes insipidus. What type of IV fluid should the nurse expect to be ordered for fluid replacement?hypotonicThe nurse is caring for patients in a primary care physician office. Which patient should the nurse recognize as being the highest risk for iodine deficiency?A 52-year-old vegan with dietary sodium restrictionsThe LPN is assisting in the care of a 51-year-old patient recovering from a hypophysectomy. Which observation should the nurse identify as needing immediate intervention?Urinary output of 800 mL in 4 hoursThe LPN admits a well-known patient to the clinic and notes that the patients face and features seem broader and coarser. Which laboratory test should the nurse expect to be prescribed for this patient?growth hormoneAfter a thyroid scan, a patient is diagnosed with a hot nodule. What should this finding suggest to the nurse?The nodule is benign and may need a biopsy to confirm the diagnosisA patient is admitted to the hospital with new-onset diabetes insipidus. Which nursing diagnoses should the nurse include in the plan of care? (Select all that apply.)Risk for Deficient Fluid Volume Knowledge Deficit related to disease processA patient being discharged is prescribed treatment for long-term hypoparathyroidism. What should the nurse include in discharge teaching? (Select all that apply.)Eat a diet high in calcium. Eat a diet high in phosphates. Have regular eye examinations. Follow up with regular laboratory tests. Take oral calcium and vitamin D supplements as prescribed.A patient is suspected of having dilutional hyponatremia. What manifestations of this disorder should the nurse expect to observe in this patient? (Select all that apply.)Nausea Headache Muscle weakness Elevated blood pressureA patient is prescribed to ingest a high-calcium diet. What foods should the nurse instruct the patient to ingest? (Select all that apply.)Sardines, salmon Milk, cheese, and yogurtA patient with suspected hyperthyroidism is scheduled for a radioactive iodine uptake test. What symptoms of hyperthyroidism should the nurse note on the medical record? (Select all that apply.)Fatigue Tremor Weight lossA patient diagnosed with syndrome of inappropriate antidiuretic hormone is scheduled for surgery in a few days. What should the nurse expect to be prescribed for this patient to help manage the symptoms until surgery? (Select all that apply.)Fluid restriction Furosemide (Lasix) Conivaptan (Vaprisol) Hypertonic saline infusionThe nurse is assisting in the preparation of a patient for a hypophysectomy. What should the nurse emphasize when teaching this patient? (Select all that apply.)Use an incentive spirometer. Avoid bending from the waist. Perform deep breathing exercises.Planning is underway to determine the best course of treatment for a patient with hyperparathyroidism. What should the nurse expect to observe when collecting data from this patient? (Select all that apply.)Fatigue Nausea Confusion DepressionWhile collecting data the nurse suspects a patient is experiencing manifestations of Addisons disease. What observations did the nurse make to come to this conclusion? (Select all that apply.)Bronzing of the skin Blood pressure 90/55 mm Hg Weight loss 10 lbs from last examination