Diabetes
The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the following symptoms during an assessment, except:
a. hypoglycemia
b. frequent bruising
c. ketonuria
d. dry mouth
a. hypoglycemia
which insulin is given for carb coverage Before a meal?
humalog/novalog
All the logs, rapid acting.
If the thyroid is enlarged, do we palpate it?
NO! it causes release of hormones
does the adrenal cortex or medulla respond to stress faster?
adrenal cortex is SLOWER and medulla is FASTER
What are we going to assess in a pt with excess growth hormone?
Enlarged hands and feet, weight gain, bone growth, htn, hypertrophy, glucose intolerance, mandibular growth, enlarged nose, large hands and feet, spaced out teeth
Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following, except:
a. integumentary inspection for the presence of brown spots on the lower extremities
b. paleness in the lower extremities
c. observation for blanching of the feet after legs are elevated for 60 seconds.
d. palpation for increased pulse volume in the arteries of the lower extremities
d. palpation for increased pulse volume in the arteries of the lower extremities
What are contraindications for taking metformin?
high Cr/BUN
dye test
Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
A. Diabetic ketoacidosis
B. Thyroid crisis
C. Hypoglycemia
D. Tetany
B. thyroid crisis
When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect:
A. Blood pressure of 130/70 mm Hg.
B. A blood glucose level of 130 mg/dl.
C. bradycardia
d. Blood pressure of 176/88 mm Hg.
d. Blood pressure of 176/88 mm Hg.
During assessment of the patient with acromegaly, the nurse would expect the patient to report
a. infertility
b. dry, irritated skin
c. undesirable changes in appearance
d. an increase in height of 2 to 3 inches per year
c. undesirable changes in appearance
differentiate between glycogenesis and glycogenolysis.
Glycogenesis: creation of glycogen from glucose
glycogenolysis: conversion of glycogen back to glucsoe
A client with diabetes mellitus visits a health care clinic. The client’s diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently, the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia?
a. prednisone
b. atenolol
c. phenelzine
d. allopurinol
a. prednisone
It is a steroid.
A female adult client with a history of chronic hyperparathyroidism admits to being non-compliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add?
A. Related to bone demineralization resulting in pathologic fractures.
B. Related to exhaustion secondary to an accelerated metabolic rate.
C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces.
D. Related to tetany secondary to a decreased serum calcium level.
A. Related to bone demineralization resulting in pathologic fractures.
Describe the following differences between Addisons and cushings: hormones and s/s
Addisons: low cortisol and aldosterone; Bronze skin, hypoglycemia, weak, low sodium, HIGH potassium
Cushings: high cortisol and aldosterone; Moon face, sodium and fluid retention, HTN, edema, hyperglycemia
Why is there insulin resistance with acromegaly? How do we test for this?
Growth hormone goes AGAINST insulin → less uptake of glucose in liver → high BG
OGTT (oral glucose tolerance test) or blood test
Describe the differences between type 1 and type 2 diabetes.
Many answers could be accepted.
which medication classes increase insulin as their action in the body? Which ones also decrease glucose?
sulfonylureas (insulin only)
meglitidies (insulin only)
DPP-4 inhihbitors (insulin and glucose)
GLP-1 (insulin and glucose)
A 67-year-old female client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders?
a. diabetes mellitus
b. diabetes insipidus
c. hypoparathyroidism
d. hyperparathyroidism
d. hyperparathyroid
too much calcium = sedation
too little calcium = tremors
What happens with adrenal crisis? What do we do?
low cortisol and aldosterone which leads to HIGH potassium and arrythmias.
MONITOR/ASSESS:
Potassium, sodium, sugar
Hook up to tele
Heart
BP, weight,
After teaching a client with acromegaly who is scheduled for a hypophysectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
a. I will no longer need to limit my fluid intake after surgery.
b. I am glad no visible incision will result from this surgery.
c. I hope I can go back to wearing size 8 shoes instead of size 12.
d. I will wear slip-on shoes after surgery to limit bending over.
c. I hope I can go back to wearing size 8 shoes instead of size 12.
size cannot be changed even after removal
A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include fasting blood glucose of 120mg/dl, temperature of 101ºF, pulse of 88 bpm, respirations of 22 bpm, and a BP of 140/84 mmHg. Which finding would be of most concern to the nurse?
a. pulse
b. BP
c. Respirations
d. temperature
d. temperature
Because that could indicate infection which can cause HHNK in type 2 diabetics
The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs using one (1) syringe. Place the steps in order.
1. inject air equal to regular dose into regular vial
2. invert regular bottle and withdraw regular dose
3. invert NPH vial and withdraw NPH dose
4. inject air equal to NPH dose into NPH vial
4. inject air equal to NPH dose into NPH vial
1. inject air equal to regular dose into regular vial
2. invert regular bottle and withdraw regular dose
3. invert NPH vial and withdraw NPH dose
Differentiate between hyper and hypothyroid.
Many answers here.
Nurse Ronn is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find:
A. Hypotension.
B. Thick, coarse skin.
C. Deposits of adipose tissue in the trunk and dorsocervical area.
D. Weight gain in arms and legs.
C. Deposits of adipose tissue in the trunk and dorsocervical area.
The nurse would question a prescription for somatropin (Genotropin) in a patient with which condition?
A. Dwarfism
B. Acromegaly
C. Growth failure
D. Hypopituitarism
B. acromegaly
Somatropin is a synthetic form of human growth hormone. Acromegaly is caused by excessive growth hormone, and thus this drug would be contraindicated