MARYVILLE NURS 623 EXAM 2 Questions And Answers
Which of the serum laboratory findings are present in the client with Cushing's syndrome?
Increased cortisol, HYPERnatremia, and HYPOkalemia
Alice, age 48, has a benign thyroid nodule. The most common treatment involves:
Watchful waiting wit...
Which of the serum laboratory findings are present in the client with Cushing's
syndrome?
Increased cortisol, HYPERnatremia, and HYPOkalemia
Alice, age 48, has a benign thyroid nodule. The most common treatment
involves:
Watchful waiting with an annual follow-up
ACE inhibitors are given to clients with diabetes who have
persistent proteinuria
A newly diagnosed client with diabetes who has an HbA1c of 7.5 is started on
therapeutic lifestyle changes (TLC) and medical nutritional therapy (MNT).
Which oral antidiabetic agent is recommended as monotherapy?
metformin
An elderly client with hyperthyroidism may present with atypical symptoms.
Which of the following manifestations are commonly seen in the elderly with
hyperthyroidism?
a-fib, depression, weight loss
Diane has had Cushing's disease for 20 years and has been taking
hydrocortisone since her diagnosis. Today, she appears with a thick trunk and
thin extremities. She has a "moon face," a "buffalo hump," thin skin with
visible capillaries, and a number of bruises that appear to be slow in healing.
To what do you attribute these symptoms?
excessive levels of cortisol
The following is a client's self-monitoring blood glucose log. The client
receives 20 units Novolin 70/30 in the morning (a.m.) and 20 units Novolin
70/30 in the evening (p.m.): Fasting a.m. pre-dinner: 90, 150, 105, 144, 101, 172,
98, 201. What changes would you make?
increase A.M. insulin
Dan, age 45, is obese and has type 2 diabetes. He has been having trouble
getting his glycohemoglobin under control. He's heard that exenatide (Byetta)
causes weight loss and wants to try it. What do you tell him?
"Let's try it. You're glycohemoglobin will be lowered and you may lose weight."
Which is the only treatment option that is curative for primary
hyperparathyroidism?
parathyroidectomy
The most common worldwide cause of hypothyroidism is:
iodine deficiency
What should be assessed for during exam on pt with HYPOparathyroidism?
chvostek's sign
Morton has Type 2 diabetes. His treatment, which includes diet, exercise, and
oral antidiabetic agents, is insufficient to achieve acceptable glycemic control.
Your next course of action is to
ADD LONG-ACTING INSULIN
Joy has gout. In teaching her about her disease, which food do you tell her is
allowed in her diet?
Broccoli
, What controls the amount of calcium in the blood?
Parathyroid
Thyroid hormones regulate
metabolism
Which tests should you order to confirm a diagnosis of hypothyroidism?
t3 & Free T4 (preferred over T4)
What are the hallmark signs of Grave's disease?
enlarged thyroid and increased T3
What is the gold standard screening for thyroid TUMOR/NODULE?
ULTRASOUND
What is the diagnostic screening for thyroid cancer?
FINE NEEDLE BIOPSY
What is the preferred treatment of Grave's disease in pregnancy
Propylthiouracil (PTU):
Before starting anti-thyroid meds what should be checked?
LIVER FUNCTIONS
what is the goal of thyroid treatment
euthyroid state
What are signs and symptoms of hypothyroidism overtreatment?
hyperglycemia; cardiac arrhythmias (Afib); adrenal insufficiency; increased
myxedema.
Hyperthyroidism causes an excessive secretion of which thyroid hormones?
T3 & T4
What are S/S of hyperthyroidism?
"Hot/buldging/fast" heat intolerance, eye buldge, tachycardia, weight loss, diarrhea,
systolic HTN, enlarged thyroid
What are S/S of HYPOthyroidism?
"cold, slow, tired" cold intolerance, slow speech, fatigue, lethargy, weight gain,
constipation, brittle nail/hair
What is the most common cause of hyperthyroidism?
Graves disease
Name the two thyroid hormones produced by the thyroid gland?
T3 & T4
Name the hormone produced by the pituitary gland, state the purpose of the
hormone
TSH; regulate the production of hormones by the thyroid gland
IN GRAVES DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE
__________
LOW; HIGH
IN HASHIMOTO'S DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE
__________
HIGH; LOW
WHAT allows the resolution of hyperthyroidism, although patients then
become hypothyroid and require thyroid replacement therapy for life
ABLATIVE DOSE IODINE
According to the American Association of Clinical Endocrinologists, the usual
dose of levothyroxine per day for full replacement?
1.6 mcg/kg per day 50-100 MCG DAY
what pt education do you give with levothyroxine?
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