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Pituitary and Adrenal Gland Problems CH 57
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Pituitary and Adrenal Gland ProblemsCH 57
Which action would the nurse take first when a patient with Cushing disease reports a weight loss of
5 lb?
a. encourage an increased intake of fluids
b. weigh the patient
c. check the specific gravity of the urine
d. auscultate the lungs for crackles - ANS b. weigh the patient
Which serum laboratory finding is most important to monitor in a patient with diabetes insipidus
(DI)?
A. sodium
B. glucose
C. potassium
D. liver function - ANS A. sodium
inability of kidneys to respond to ADH leads to increased sodium levels
When the nurse is planning care for a patient diagnosed with acute adrenal insufficiency, which
hormone deficit will guide the interventions? (Select all)
A. cortisol
B. prolactin
C. androgen
D. aldosterone
E. growth hormone - ANS A. cortisol
D. aldosterone
patient with acute adrenal insufficiency will have severe deficits of cortisol and aldosterone.
Which laboratory test would the nurse expect to be prescribed for a patient who is admitted to the
hospital with acute adrenal insufficiency? (Select all)
A. sodium
,B. cortisol
C. albumin
D. potassium
E. liver function - ANS A. sodium
B. cortisol
D. potassium
low sodium, low salivary cortisol levels, low fasting blood glucose, elevated potassium, increased
BUN
Which intervention would the nurse delegate to the assistive personnel (AP) when caring for a
patient who is hospitalized with suspected Cushing disease?
A. assess skin turgor and mucous membranes for hydration status
B. discuss dietary restrictions needed for 24-hour urine testing
C. plan ways to control the environment to avoid stimulating the patient
D. remind the patient to avoid drinking coffee and changing positions suddenly - ANS D. remind the
patient to avoid drinking coffee and changing positions suddenly
drinking caffeinated beverages and changing position suddenly are not safe for a patient with a
potential adrenal gland tumor because of the effects of catecholamines
Which laboratory finding is consistent with a patient diagnosed with hyperaldosteronism? (Select all)
A. arterial pH 7.48
B. serum sodium 148 mEq/L
C. serum calcium 8.9 mg/dL
D. serum glucose 358 mg/dL
E. serum potassium 5.3 mEq/L - ANS A. arterial pH 7.48
B. serum sodium 148 mEq/L
Hyperaldosteronism - alkalotic and hypernatremia
A patient suspected of having Cushing disease is scheduled for dexamethasone suppression testing.
Which statement by the patient indicates the need for further teaching?
, A. my blood will be drawn over 3 days
B. for 24 hours, my urine will be collected
C. this test will show whether i have high cortisol levels
D. i will be given set doses of dexamethasone - ANS A. my blood will be drawn over 3 days
patient will not have blood drawn. 24-hour urine collection follows drug admin. dexamethasone
suppression testing can screen for hypercortisolism and may take place overnight or over 3-day
period. Set doses of dexamethasone are given
Which finding in a patient with syndrome of inappropriate antidiuretic hormone (SIADH) is a priority
to report to the health care provider?
A. lethargy
B. dependent edema
C. serum sodium of 115 mEq/L
D. intake of 1100mL, output of 1250 mL - ANS C. serum sodium of 115 mEq/L
SIADH = increased risk for hyponatremia, can lead to seizures and coma
Which is a secondary cause of adrenal insufficiency? (select all)
a. tuberculosis
b. pituitary tumors
c. hypophysectomy
d. autoimmune diseases
e. abrupt discontinuiation of corticosteroids - ANS b. pituitary tumors
c. hypophysectomy
e. abrupt discontinuiation of corticosteroids
secondary causes of adrenal insufficiency include pituitary tumors, hypophysectomy, and abrupt
discontinuation of corticosteroid therapy.
Primary causes include TB and autoimmune diseases
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