Test 1 Nursing the Adult

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Test 1 Nursing the Adult
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2010-01-17 18:24:35
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Endocrine Electrolytes
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Nursing the Adult
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  1. What is the total average intake for 24hrs?
    2500mL
  2. The control of fluid balance is managed by what 4 things?
    • 1. The thirst mechanism
    • 2. ADH, causes reabsorption of water from the kidneys
    • 3. Aldosterone and atrial natriuretic peptide, (ANP), regulaters the reabsorption of water and sodium ions from the kidney tubules
    • 4. Baroreceptors in the carotid sinus and aortic arch, which detect pressure changes.
  3. The Intracellular fluid is high in what?
    Potassium K+
  4. The Extracellular Fluid is high in what?
    Sodium Na+
  5. This is fluid within the blood vessels. Consist of plasma, contain large amounts of protein and electrolytes
    Intravascular Fluid
  6. Fluid in the spaces surrounding the cells. High in Na+. Example Lymph.
    Intersitial Fluid
  7. Fluid in the aqueous humor, saliva, and CSF.
    Transcellular Fluid
  8. How much water is in Fat Cells?
    None
  9. When substances move from a higer concentration to lower concentration until they are evenly distributed. This is possible due to kenetic motion. Glucose, carbon dioxide, water, and other small ions and molecules move by this.
    Diffusion
  10. The movement of pure solvent (liquid) across the membrane. Goes from area of low concentration to high concentration.
    Osmosis
  11. Equal solute concentration
    Isotonic
  12. Greater solute concentration
    Hypertonic
  13. Lesser solute concentration
    Hypotonic
  14. Active transport requires what
    ATP/ Energy
  15. Pt ubalble to take in sufficient quanities of fluid because of impaired swallowing, extreme weakness, disorientation or coma, or the unavailability of water are at risk for
    Deficient Fluid Volume
  16. Pt who lose excessive amounts of fluids through prolonged vomiting, diarrhea, hemorrhage, diaphoresis (sweating), excessive wound drainage, or diuretic therapy are at risk for
    Deficiet Fluild Volume
  17. Pt. is presented with signs of THIRST, poor skin turgor, weight loss, weakness, postural hypotension, decreased urine production, dark concentrated urine, dry mucous membranes, rapid weak thready pulse, you would expect the Dr. to Dx this pt. with
    Dehydration
  18. Pt present with weight gain, slow bounding pulse, elevated BP, crackles in lungs, decreased serum sodium, firm SubQ tissue, you would expect the Dr. to Dx this pt with
    Overhydration
  19. What is the most accurate measure of fluid gain or loss for any age group
    Weight
  20. The pt is Dx with fluid volume deficit what would you want to push to restore the fluid deficit
    Water and Electrolytes
  21. Prolonged vomiting can lead to what deficits
    • Na+
    • K+
    • Metabolic Acidosis
  22. What is the biggest loss of K+
    Diarrhea
  23. What does excessive fluid volume due to BP
    Jacks it up
  24. Discuss the tx for Excessive Fluid Volume
    • Bedrest
    • HOB up
    • O2 and Pulse Ox
    • Daily Wt
    • I & O
    • Fluid Restriction
    • Na+ restriction in diet
  25. What is the danger of Lasix?
    6hr Non-K+ sparing Diuretic
  26. The normal range for this is 135-145 mEq/L
    This is a major ation of the Extracellular Fluid
    Na+
  27. The normal range for this is 3.5-5.0 mEq/L
    Major intracellular cation
    K+
  28. Alot of fluid intake will do what to Na+ levels
    Decrease
  29. No fluid intake will do what to Na+ levels in the body?
    Increase
  30. Normal range is 21.5-4.5 mEq/L
    Necessary for the formation of ATP
    Phosphate PO4-
  31. The normal range is 8.4 - 10.6 mg/dL
    Necessary for Nerve transmission
    Ca+
  32. The normal range is 96-106 mEq/L
    Help maintain acid-base balance.
    Chloride Cl-
  33. Normal Range is 1.3-2.5 mEq/L
    Magnesium
  34. The pH of body fluids is slightly
    Alkaline 7.35-7.45
  35. Name the 3 mechanisms that contal or try to rebalance pH
    • 1. Buffer pairs
    • 2. The respiratory system
    • 3. The kidneys
  36. What does hyperventilation result in?
    Respiratory Alkalosis
  37. What follows loss of hydrochloric acid from the stomach?
    Metabolic Acidosis
  38. A 28 yr old pt weighs 160 lbs. The pt body fluids account for about?
    A. 20lbs.
    B. 60lbs.
    C. 80lbs.
    D.40 lbs.
    C. 80 lbs
    (this multiple choice question has been scrambled)
  39. In terms of planning for a pt body fluid needs the LPN should understand that throughout the life span, there is:
    A gradual decline in body water
  40. The componet of body fluid that provieds transportation of nutrients and waste products is:
    A. Na+
    B. K+
    C. Ca+
    D. water
    D. Water
    (this multiple choice question has been scrambled)
  41. To plan care for a pt who has edema the LPN must know that the most important electrolyte in the retention of water in the body tissues is:
    A. Magnesium
    B. K+
    C. Na+
    D. Ca+
    C. Na+
    (this multiple choice question has been scrambled)
  42. A pt is to be given aniemetic. The major side effects of antiemetics include:
    A. oversedation and hypotension
    B. constipation and dehydration
    C. diarrhea and stomach cramps
    D. irritability and nervousness
    A. oversedation and hypotension
    (this multiple choice question has been scrambled)
  43. What of the measures should be included in the care of a pt with severe vomiting and diarrhea?
    A. providing a restful environment
    B. providing a high-protein diet
    C. preventing fluid excess
    D. correcting potassium deficit
    D. Correcting potassium deficit
    (this multiple choice question has been scrambled)
  44. A pt is on a low Na+ diet. Which of the following foods are allowed on a low-sodium diet.
    A. Fresh Fruit
    B. Lunch Meat
    C. Olives
    D. Cheese
    A. Frest Fruit
    (this multiple choice question has been scrambled)
  45. The pt has a blood pH of 7.45, which is considered
    slightly alkaline
  46. A pt lungs must be well ventilated because hypoventiliation of the lungs results in:
    A. acidosis due to excessive loss of CO2.
    B. acidosis due to decreased elimination of CO2.
    C. alkalosis due to decreaed elimination of CO2.
    D. alkalosis due to excessive loss of CO2.
    B. acidosis due to decreased elimination of CO2.
    (this multiple choice question has been scrambled)
  47. When a pt has vomiting, diuresis with K+ loss, or interinal fistulae, this can lead to :
    A. alkalosis from excessive loss of acids
    B. alkalosis from loss of carbonate
    C. acidosis form loss of carbonate
    D. acidosis from increased production of carbonic acid
    A. alkalosis from excessive loss of acids
    (this multiple choice question has been scrambled)
  48. A pt is to have an infustion of an isotonic solution, which is one that has:
    A. a higher osmotic pressure than that of body fluids
    B. a lower osmotic pressure than that of body fluids
    C. a dissimilar pressure fomr that of body fluids
    D. the same osmotic pressure as that of body fluids
    D. the same osmotic pressure as that of body fluids.
    (this multiple choice question has been scrambled)
  49. When a pt recieves a hypotonic solution IV. The LPN should expect the pt to receive:
    A. there is no net loss of water acrros the cell membrane
    B. the cells begin to shrink as water is pulled from the intracellular compartment
    C. the cells begin to swell as water enters the intracellular compartment
    D. there is no change in the cells because there is no fluid shift
    C. The cells begin to swell as water enters the intracellular compartment
    (this multiple choice question has been scrambled)
  50. A pt. has a nursing diagnosis of Deficient fluid volume R/T vomiting and diarrhea. Which of the following measures is most likely to be implemented to correct this stituation:
    A. NPO
    B. IV therapy
    C. Force Fluids
    D. soft diet
    B. IV therapy
    (this multiple choice question has been scrambled)
  51. A pt is instructed to eat foods high in K+, which include:
    A. aged cheese
    B. tomatoes
    C. bananas
    D. eggs
    C. bananas
    (this multiple choice question has been scrambled)
  52. A 54 year old pt has been admitted to the unit with a K+ level of 2.6 mEq/L. The nurse would anticipate Mr. Hernandez to exhibit:
    A. peaked T waves on ECG
    B. muscle rigidity
    C. muscle flaccidity
    D. rapid respirations
    C. Muscle faccidity
    (this multiple choice question has been scrambled)
  53. A pt with Cushing disease will most likely exhibit signs and symptoms of
    A. hypermagnesemia
    B. hypocalcemia
    C. hypernatremia
    D. hypokalemia
    C. hypernatremia, pt retains sodium and water
    (this multiple choice question has been scrambled)
  54. Which of the following pt is most at risk for fluid volume overload?
    A. a 72 year old with influenza
    B. a 35 year old with renal disease
    C. a 60 year old with psoriasis
    D. a 40 year old with meningitis
    B. a 35 year old with renal disease
    (this multiple choice question has been scrambled)
  55. A pt with a diagnosis of DM in metabolic acidosis has a blood glucose level of 250 mg/dl and has been admitted to your unit. Which symptom is most likely to accompany ketoacidosis:

    A. tremors
    B. polydipsia
    C. perspiration
    D. oliguria
    B. Polydipsia
    (this multiple choice question has been scrambled)
  56. List 3 tx or nursing measures that can lead to water intoxication:
    • 1. IV fluids too quickly
    • 2. Given water tap enemas
    • 3. Drink too much water and can't eliminate properly
  57. What hormones are secreted by the Thyroid Gland?
    • T3
    • T4
    • Calcitonin
  58. Intake of what is needed for the thyroid to secrete its hormones
    Iodine and Protein
  59. What is the most important day to day regulator of the metabolic rate?
    Thyroid
  60. What is the function of hte Parathyroid gland?
    Secretes parathormone
  61. A low calcium level will stimulate the secretion of ?, which increases the plasma level of calcium
    parathormone
  62. What is the most important regulator of blood calcium levels?
    Parathormone
  63. What 2 hormones are secreted by the adrenal medulla?
    Epinephrine and Norepinephrine
  64. Name the 3 hormones secreted by the adrenal cortex.
    • 1. Mineralcorticoids
    • 2. Glucocorticoids
    • 3. Gonadocorticoids
  65. The mineralcorticoids affect what 3 things
    • 1. Sodium
    • 2. Potassium
    • 3. Chloride
  66. The cheif mineralocorticoid is
    Aldosterone
  67. This hormone promotes conservation of water by acting on the kidneys to retain sodium in exchange for potassium
    Aldosterone
  68. The glucocorticoids are essential for proper utilization of what 3 things
    • Carbs
    • Protein
    • Fats
  69. The primary glucocorticoid is what
    Cortisol
  70. What does cortisol do to glucose levels in the blood
    Increases
  71. Both aldosterone and cortisol are controlled by
    ATCH
  72. The pancreas secretes what
    Insulin
  73. What cells secrete insulin
    Beta
  74. What cells secrete glucagon
    Alpha
  75. This is needed for the cells of the body to be able to utilize glucose as fuel
    Insulin
  76. What are 5 affects of aging on the Endocrine System?
    • 1. Pit is smaller
    • 2. Thyroid becomes lumpy, metabolism declines
    • 3. Blood glucose levels rise
    • 4. Older adults experience hypoglycemia more quickly
    • 5. Immune system
  77. What 4 things may effect the result of a Serum T3, Serum T4 and TSH Test?
    • 1. Asprin
    • 2. Iodine containing meds
    • 3. Contrast Media
    • 4. Other meds
  78. What pt teaching should you given when you are doing a Radioactive Iodine Uptake or Thyroid Scan test?
    • 1. Must not be pregnant or lactating
    • 2. Radiacitve iodine is small
    • 3. 24hr specimen if required
  79. If a RAIU detects a Hot spot you could expect to tell the pt that they have a:
    Non Malignant Nodule
  80. If a RAIU detects a "Cold Spot" then you could expect to tell the pt:
    That they found a Malignant Nodule
  81. What test determines the degree of Diabetic control of blood sugar over the preceding 6-8 wks
    Glycosylated Hemoglobin or HbA1C
  82. What hormones are secreted by the Anterior Pituitary?
    • GH
    • TSH
    • ACTH
    • FSH
    • LH
    • Prolactin
  83. The adenohypophysis is also known as
    Anterior Pit
  84. The target tissue is most tissues in the body
    The principal action is it stimulates growth by promoting protein synthesis
    WHAT IS THE HORMONE
    Growth Hormone
  85. The target tissue is Thyroid Gland
    The principal action is to increase secretion of thyroid hormone and increases the size of the thyroid gland
    WHAT IS THIS HORMONE
    TSH
  86. The target tissue is Adrenal Cortex
    The principal action is to increase the secretion of the adrenocortical hormones
    WHAT IS THE HORMONE
    ATCH
  87. The target tissue is Ovarian Follicles in female, and Seminiferous tubules in Males
    The principal action is follicle maturation (ova) and estrogen in the female, and sprematogenesis in the male
    WHAT IS THE HORMONE
    FSH
  88. The target tissue is Ovary in the females, and Testes in the Male
    The principal action is Ovulation, progesterone production in females, and Testosterone production in Males
    WHAT IS THE HORMONE
    LH
  89. The target tissue is mammary gland
    The principal action is to stimmulates milk production
    WHAT IS THE HORMONE
    Prolactin
  90. What are the 2 hormones stored in the Posterior Pituitary Gland, and synthesized in the Hypothalamus?
    • ADH
    • Oxytocin
  91. What is the neruohypophysis also known as
    Posteior Pituitary
  92. The target tissue is Kidneys
    The principal action is to increase water reabsorption (decreases water loss in urine)
    Osmoreceptors detect increase in Na+ which send for signal to secrete....
    WHAT IS THE HORMONE
    ADH
  93. The target tissue is Uterus; mammary gland
    The principal action is to increase uterine contractions; stimulates ejection of milk from mammary gland
    Let Down Reflex
    WHAT IS THE HORMONE
    Oxytocin
  94. What 3 hormones does the thyroid secrete
    • T3
    • T4
    • Calcitonin
  95. The target tissue is most body cells
    The principal action is to increase meatbolic rate
    WHAT ARE THE 2 HORMONES
    • T3
    • T4
  96. The target tissue is Primarly Bone
    The principal action is to decrease bone calcium by inhibiting bone breakdown and release of calcium
    WHAT IS THE HORMONE
    Calcitonin
  97. What hormone does the parathyroid secrete
    parathormone
  98. The target tissue is bone, kidney, digestive tract
    The principal action is to increase blood calcium by stimulation bone breakdown and release of calcium; increases calcium absorption in the digestive tract
    WHAT IS THE HORMONE
    Parathormone
  99. What hormones does the adrenal cortex secrete
    • Mineralocorticoids
    • Glucocorticoids
    • Gonadocorticoids
  100. The target tissue is Kidney
    The principal action is to increase Na+ reaborption and K+ excretion in kidney tubules, Increase water retension
    WHAT IS THE HORMONE
    Aldosterone
  101. The target tissue is most body tissues, and the Liver
    The principal action is to increase blood glucose levels; inhibits inflammation and immune responses
    WHAT IS THE HORMONE
    Cortisol
  102. The target tissue is Heart, Blood vessels, liver and adipose
    The principal function is to help cope with stress, increases ht rt. and BP
    WHAT ARE THE 2 HORMONES
    Epi and Norepi
  103. The target tissue is liver
    The principal action is to increase breakdown of glycogen ot increase blood glucose levles
    WHAT IS THE HORMONE
    Glucagon
  104. The target tissue is general, but especially liver, skeletal muscles, adipose
    The principal action is to decrease blood glucose level by facilitating uptake and utilization of glucose by cells
    WHAT IS THE HORMONE
    Insulin
  105. The Pineal gland secretes what
    Melatonin
  106. The target tissue is Hypothalamus
    The principal action it to inhibit gonadotropins-releasing hormone, regulates daily rhythms
    WHAT IS THE HORMONE
    Melatonin
  107. What does the thymus secreted
    Thymosin
  108. The target tissue is tissues involved in the immune response
    The principal action is to delvelop the immune system
    WHAT IS THE HORMONE
    Thymosin
  109. What is the tempurature regulator
    Hypothalamus
  110. A pt is admitted to the hospital with a suspected diagnosis of hyperthyroidism. She asks you about the throid scan for which she is scheduled this morning. You should tell her that the test is done to:

    A. determine underactivity of thyroid cells
    B. collect a blood sample for analysis
    C. detect abnormal areas of growth or tissue in the thyroid
    D. evaluate the thyroid's ability to accumulate iodine
    C. detect abnormal areas of growth or tissue in the thyroid
    (this multiple choice question has been scrambled)
  111. Three of the following are signs or symptoms of hyperthyroidism. Which one is not?

    A. emotional insability
    B. mental sluggishness
    C. increase in appeptite
    D. hyperactivity with increasing sense of fatigue
    B. mental sluggishness
    (this multiple choice question has been scrambled)
  112. Immediately after a pt has a thyroidectomy, the pt should be placed in which of the following positions?

    A. Sims' left lateral
    B. Fowler's
    C. Trendelenburg
    D. Supine
    B. Fowler's
    (this multiple choice question has been scrambled)
  113. During the immediate postoperative period, a pt who has had a thyroidectomy should be watched for:

    A. facial paralysis, hemorrhage, and shock
    B. edema, hoarseness, and increase in VS
    C. vomiting, diarrhea, and abdominal distention
    D. a drop in BP, dyspnea, and dehydration
    B. edema, hoarness, and increase in VS
    (this multiple choice question has been scrambled)
  114. Muscular twitching and cramps in the muscles following thyroidectomy may indicate:

    A. damage to cervial nerves
    B. early signs of epilepsy
    C. potassium depletion
    D. damage to the parathyroid glands during surgery
    D. damage to the parathyroid glands during surgery
    (this multiple choice question has been scrambled)
  115. In the postoperative period, you should observe a pt who has had a thyroidectomy for evidence of thyroid crisis. Two common signs of thyroid crisis are:

    A. twitching of mucles and severe convulsions
    B. depression and fatigue
    C. respiratory embarrassment and hoarseness
    D. extreme temperature elevation and rapid pulse rate
    D. extreme temperature elevation and rapid pulse rate
    (this multiple choice question has been scrambled)
  116. The LPN can expect thyroid crisis to be tx by:

    A. elevating the blood pressure and maintaining body temperature and normal level
    B. elevating the heart rate and replacing fluids
    C. reducing calcium and phosphorus levles
    D. reducing the body temperature and lowering the pulse rate
    D. reducing the body temperature and lowering the pulse rate
    (this multiple choice question has been scrambled)
  117. When you evaluate the tx of a hyperthyroid pt who has received oral radioactive iodine, the pt describes bieng very tired and lethargic. You should know that this indicates that:

    A. the treatment is insufficient
    B. infection may be present
    C. the treatment is working
    D. thyroid replacement is needed
    C. the treatment is working
    (this multiple choice question has been scrambled)
  118. A 42 year old pt complains that she has been losing a lot of her hair, is fatigued, and is cold all the time. You should recognize that these symptoms are indicative of:

    A. hypothyroidism
    B. hypoparathyroidism
    C. hyperthyroidism
    D. hyperparathyroidism
    A. Hypothyroidism
    (this multiple choice question has been scrambled)
  119. A pt is dx as having Addison's Disease. This condition is the result of :

    A. overfunctioning of hte pituitary and hypothalamus
    B. insufficiencies of the mineralocorticoids and glucocorticoids
    C. a secreting tumor of the adrenal cortex
    D. excesiive secretion of adrenocorticotropic hormone
    B. insufficiencies of the mineralocorticoids and glucocorticoids
    (this multiple choice question has been scrambled)
  120. In addition to generalized malaise and muslce weakness, three of the following symptoms are also common when a pt has Addison's disease. Which one in not a symptom:

    A. Muscle pain
    B. Orthostatic hypotension
    C. Headache
    D. Vulnerability to cardiac arrhythmias
    C. Headache
    (this multiple choice question has been scrambled)
  121. When caring for a pt with Addison's disease, you should observe for and report which of the following findings?

    A. edema in the extremeties
    B. a sudden drop in BP
    C. flatulence
    D. pulse below 65 bpm
    B. a sudden drop in BP
    (this multiple choice question has been scrambled)
  122. Three of the following are symptoms of Cushings syndrome. Which one is not?

    A. hypotension
    B. moonface
    C. fatty swellin in the intrascapular space
    D. Abdominal Distention
    A. Hypotension
    (this multiple choice question has been scrambled)
  123. When doing a discharge teaching for a pt with Addison's disease, you should explain to the pt that getting an infection may:

    A.destroy more adrenal tissue
    B. cause massive wt loss
    C. precipitate crisis
    D. make meds infeffective
    C. precipitate crisis
    (this multiple choice question has been scrambled)
  124. A pt has DI. You should anticipate giving which of the follwoing drugs:

    A. Fluorinef
    B. Pitressin
    C. Insulin
    D. Cortisone
    B. Pitressin
    (this multiple choice question has been scrambled)
  125. A pt who has hyperthyroidism has a nursing diagnosis of "anxiety R/t nervousness and agitation. Because of this nursing diagnosis, which of the following interventions should be included in the pt's care?

    A. stressing the importance of complying with the tx regimen
    B. encouraging questions about options for tx
    C. keeping environmenal stimuli to a minimum
    D. maintaining the temperature of the room slightly above normal
    C. keeping the environmental stimuli to a minimum
    (this multiple choice question has been scrambled)
  126. If a pt has hypoparathyroidism, the pt's chief symptoms is likely to be:

    A. decreased muscle tone
    B. decreased thirst
    C. tetany
    D. increased urinary ouput
    C. tetany
    (this multiple choice question has been scrambled)
  127. Aldosterone's major function is to:

    A. control fat and protein absorption
    B. counteract the inflammatory response
    C. increase glucose levels in the body
    D. conserve sodium and water in the body
    D. conserve water and sodium in the body
    (this multiple choice question has been scrambled)
  128. A pt is at risk for developing osteoporosis if she is producing abnormal:

    A. calcitonin
    B. adrenalin
    C. aldosterone
    D. cortisol
    A. calcitonin
    (this multiple choice question has been scrambled)
  129. A pt is admitted with a suspected endocrine disorder. His symptoms include changes in blood glucose levles, weakness, and irritability. Diagnostic procedures to determine etiology of the problem would include:

    A. x-rays
    B. lab studies
    C. MRI
    D. ultrasound
    B. lab studies
    (this multiple choice question has been scrambled)
  130. A pt with deficiency of which of the following hormones will exhibit symptoms of DI?
    A. estrogen
    B. glucagon
    C. ADH
    D. insulin
    C. ADH
    (this multiple choice question has been scrambled)
  131. When a pt has alterations in serum Ca+ and PO4-, which of the following is dysfunctional?

    A. pancreas
    B. adrenal
    C. parathyroid
    D. thyroid
    C. parathyroid
    (this multiple choice question has been scrambled)
  132. The nurse would monitor a pt for signs and symptoms of glucose intolerance when a pt is dx with which of the following disorders? (select all that apply)

    a. acromegaly
    b. cushings syndrome
    c. pheochromocytoma
    d. graves disease
    • b. cushings
    • c. pheochromocytoma
  133. A pt is scheduled for thyroid function tests in the morning. Pt preparation for the diagnostic procedure includes: (select all that apply)

    a. keeping the pt NPO after Midnight
    b. asking the pt if she has recently eaten shrimp or clams
    c. explaining to the pt that the dose of radioactivity she will be exposed to during the test is very small
    d. ascertaining if the pt is claustrophobic
    e. instructing her to discard her first mornings urine
    b and C
  134. A pt is dx with a thyroid disorder. You should anticipate that the pt is mostly likely to have problems with:

    A. bone fragility
    B. increased blood glucose
    C. metabolic rate
    D. water reabsorption
    C. metabolic rate
    (this multiple choice question has been scrambled)
  135. The dr orders a dexamethasone suppression test to assist in the dx of cushings syndrome. An appropriate nursing action would be to:

    A. collect clean-catch urine specimen
    B. admin vasopressin SC as ordered
    C. check orders for drugs to be withheld
    D. note the start and end time on the lab slip
    C. check orders for drugs to withheld
    (this multiple choice question has been scrambled)
  136. Which of the following is at greatest risk for injury related to bone fracture:

    A. pt with a pancreatic disorder
    B. pt with a parathyroid disorder
    C. pt with thyroid disorder
    D. pt with a testicular disorder
    B. pt with a parathyroid disorder
    (this multiple choice question has been scrambled)
  137. This tumor secretes GH leading to continued growth of bones and soft tissue
    Tumor of the pituitary usually a genign pituitary adenoma.
  138. Excessive secretion of GH caused what in children
    Gigantism
  139. Excessive secretion of GH in adults
    Acromegaly
  140. What is tx for a pituitary tumor
    Hormone Therapy
  141. Removal of the pituitary gland
    Hypophysectomy
  142. A post op hypophysectomy pt is kept in what position
    Semi Fowlers
  143. A rare disorder characterized by a decrease in the level of one or more pituitary hormones
    hypofunction of the pit gland
  144. What is the most common cause of pituitary hypofunction
    Tumor
  145. What is used to replace GH
    Somatropin via SubQ Injection
  146. Decreased muscle mass, pathologic fractures is shown in what diminished hormone secretion
    GH
  147. Menstrual irregularities, diminished libido, decreased breast size, testicular atrophy, impotence, decreased facial hair is shown when what hormone diminishes
    • FSH
    • LH
  148. Weakness, fatigue, headache, postural hypotension, decreased tolerance for stress, susceptibility to infection is shown when which hormones are diminished
    • ACTH
    • Cortisol
  149. Cold intolerance, constipation, fatigue, lethargy, weigh gain is shown when which hormone is diminished
    Thryoid
  150. Your pt is experiencing profound diuresis, thirst, weakness, fatigue from nocturia, wt loss, and poor skin turgor. What do you expect the dr to dx this pt with
    DI
  151. List the 3 primary mechanisms of DI:
    • 1. Central DI
    • 2. Nephrogenic DI
    • 3. Dispogenic DI
  152. This mechanism of DI is associated with brain tumors, and head injury
    Central
  153. This mechanism of DI is caused by drug therpay or kidney disease
    Nephrogenic DI
  154. This mechanism of DI is caused by excessive water intake and is sometimes associated with schizophrenia
    Dispogenic DI
  155. Explain the Tx for DI
    Replacement of fluid and electrolytes, along with hormone therapy.
  156. This is oppisite of DI. Excessive amounts of ADH are produced, resulting in fluid retention
    Syndrome of Inappropriate ADH or SIADH
  157. You pt is experiencing symptoms of confusion, loss of consciousness, wt gain, and edema. Her urine output is diminished. She is experiening muscle cramps and weakness.When you listen to her lungs you notice crackling. You would expect the dr to dx this pt with
    SIADH
  158. Explain the tx for SIADH
    Restricting fluid to 500-1000 ml per day. Admin sodium chloride, diuretics, and demeclycyline to increase free water clearance.
  159. Your pt has an enlargement on the front of her neck. She is complaining that she is having difficulty swallowing. What would you expect the dr to dx this pt with.
    Goiter
  160. Explain the tx for a goiter
    Iodine
  161. What nursing considerations should you be aware of when tx a person with a goiter.
    Iodine preparations should be well diluted and given through a straw because they can cause staining to the teeth.
  162. What is another name for Graves Disease
    Hyperthyroidism.
  163. Your pt is a 45 yr old woman. She is present with symptoms of wt loss, nervousness, weakness, insomina, tremulousness, agitation, tachycardia, palpitations, ankle edema, difficulty concentrating, diarrhea, increased thirst, decreased libido. Upon assessment you notice exophthalmos. What would you expect the dr to dx this pt with.
    • Graves Disease
    • Hyperthyroidism
  164. Explain the tx for Graves Disease
    • Radio active iodine
    • Antiythyroid drugs
  165. When a pt in not responding to iodine tx or antithyroid meds they may have to undergo a
    Thyroidectomy
  166. Your pt who is post op from recieving a thyroidectomy is presenting with symptoms of increased pulse, increased respiration rate, tetany, and rise in body temp. What should you do STAT
    Report to charge nurse or dr
  167. What is a complication in thyroidectomy that is caused by a sudden increase in the output of thyroxine caused by the manipulation of the thyroid as it is being removed
    Thyroid Storm
  168. Your post op pt from a thyroidectomy is present with 106 degree fever, 200 bpm, rapid respirations, apprehension and restlelessness, what do you anticipate
    Thyroid storm which must be tx quickly
  169. Myxedema is also known as
    Hypothyroidism
  170. Your pt is a 8 wk old infant. The infant is presenting with signs of delayed physical growth, mental growth, sluggish. What do expect the dr. to dx this infant with
    Cretinism
  171. Your pt is a 32 year old presenting with a decreased appetite, wt gain, bagginess under the eyes, swelling of the face, lethargic, slurred speach, abdominal distention, depression, husky voice, dry scaly skin, brittle nails, easy brusing, and nonpitting edema. What do you expect the dr. to dx this pt. with
    Myxedema
  172. What is the tx for myxedema
    Replacement of thyroid hormones
  173. What should you keep in mind when dealing with pt that have been dx with myxedema
    • 1. Cold intolerence
    • 2. Dont rush pt
  174. A pt who presents with painless enlargement of the thyroid gland, and dysphagia is most likely to be suffering from what
    Thyroiditis or Hasimotos
  175. Explain the tx for hosimoto's disease
    Given thyroid hormone to prevent hypothyroidism and suppress TSH secretion.
  176. What is the most common form of thyroid cancer
    Papillar carcinoma.
  177. Your pt presents with muscle tetany, positive chvosteks and trousseaus sign, mild tingling, muscle cramps, and irritability. What do you expect the dr. to dx this pt with
    Hypoparathyroidism
  178. Explain the tx for hypoparathyroidism
    Raise the calcium levels to a normal range. Milk, yogurt, and chese are high in phosphorus and therefore not advised.
  179. Your pt is a 62 year old postmenopausal woman. She is presenting with adenoma, dehydration, confusion, lethargy, N & V, wt. loss, thirst, hypertension. Upon assessment you notice that she has a right fractured femur. What do you expect the dr to dx this pt with
    Hyperparathyriodism
  180. Explain the tx for hyperparathyroidism
    • Infusion of isotonic sodium chloride
    • admin of diuretic
    • Phosphate Therapy
  181. Your pt is presenting with intermittent unstable hypertension, diaphoresis, anxiety, severe headache, and palpations. What do you expect the dr to dx this pt with
    Pheochromocytoma
  182. This is a rare tumor of the adrenal medulla that secretes catchcholamines (epi and norepi).
    phecochromocytoma
  183. Explain the tx for pheochromocytoma
    adrenalectomy
  184. Your pt is presenting with signs of generalized malaise, muscle weakness, muscle pain, othrostatic hypotension, cardiac dysrythmia, anorexia, flatulence, and diarrhea. You would expect the dr to dx with pt with
    • Adrenocortical Insufficiency
    • Addisons Disease
  185. What is also known as Adernocortical Insufficiency
    Addisons Disease
  186. Explain the tx for Addisons disease
    • Life long therapy replacement
    • hydrocortisone
    • fludrocortisone
  187. Physical stress form the flu or other infection can tip the scales for a pt with Addison's disease and send them into
    crisis
  188. Excess Adrenocortical Hormone is also known as
    Cushings Syndrome
  189. A pt presents with painful fatting swellings in the intrascapular space (buffalo hump) and facial area (moon face), enlarged abdomen with thin extremities, easily brusing, impotence, amenorrhea, hypertension, hirsutism, streaked purple markings in the abdominal area. You would expect the dr to dx this pt with
    Cushings Syndrome
  190. Explain tx of cushings syndrome
    • microsurgy on the pituitary gland
    • radiation
    • keocanazole
  191. The most common cause of cushings is
    prolonged use of corticoids for chronic inflammatory disorders such as COPD, RA, Crohns Disease
  192. What is oversecreting in cushings sydrome
    Cortisol
  193. A pt has been admitted for management of hypoparathyroidism. The nurse should anticipate an order for:

    A. potassium
    B. calcium
    C. iron
    D. magnesium
    B. calcium
    (this multiple choice question has been scrambled)
  194. A pt with addisons disease will most likely exhibit which of the follwoing symptoms:

    A. hirsutism
    B. purple striae
    C. hypertension
    D. Bronze skin pigmentation
    D. bronae skin pigment
    (this multiple choice question has been scrambled)
  195. A pt with Cushings disease should be instructed to :

    A. litmit dietary sodium
    B. avoid alochol
    C. increase servings of dark green leafy veggies
    D. limit the amount of dietary protein
    A. litmit dietary sodium
    (this multiple choice question has been scrambled)
  196. A pt with a pituitary tumor will most likely exhibit symptoms of:

    A. alterations in blood glucose
    B. alteration in visual activity
    C. frequent diarrhea
    D. urticaria
    B. alteration in visual activity
    (this multiple choice question has been scrambled)
  197. Which electrolyte is directly affected by the hormone secreted by the parathyroid:

    A. sodium
    B. potassium
    C. calcium
    D. magnesium
    C. calcium
    (this multiple choice question has been scrambled)
  198. A pt with acromegaly will most likely exhibit which of the following symptoms:

    A. fatigue
    B. frequent infections
    C. wt loss
    D. bone pain
    D. bone pain
    (this multiple choice question has been scrambled)
  199. You are caring for a pt with Graves Disease.Which of the following findings would indicate a complication of this pts disease process:

    A. tachycardia
    B. urinary frequency
    C. SOB
    D. extreme fatigue
    C. SOB
    (this multiple choice question has been scrambled)
  200. You are caring for a pt after a thyroidectomy. Your priority should be to:

    A. maintain the pt in a supine positions, with sandbags placed on either side of her head and neck
    B. encourage the pt to turn her head side to side to promote drainage of oral secretions
    C. maintain the pt in a semi-fowlers position, with her head back and neck supported with pillows
    D. encourage the pt to TCDB q 2hrs, with her neck in a flexed position
    C. maintain the pt in a semi-fowlers position
    (this multiple choice question has been scrambled)
  201. What type of Diabetes does the body's immune system destroy the beta cells
    Type 1 IDDM
  202. Which type of DM requires injections of Insulin to maintain life because they produe little or no insulin on their own
    Type 1
  203. People that have type 1 DM are more prone to what
    Ketoacidosis
  204. What type of DM is related to insulin resistence
    Type 2
  205. A pt is presented to you with symptoms of polyuria, polydipsia, polyphagia, rapid wt loss, irritability, weakness, fatigue and N & V. What do you expect the dr to dx this pt with
    Type 1 DM
  206. A pt is presented to you with wt gain, poor healing of wounds, blurred vision, increased fatigue, numbness in the feet. Upon getting a hx, he tells you that his mother and grandfather have DM. What do you expect the dr to dx this pt with
    Type 2 Dm
  207. What 4 factors influence the pt development of DM
    • 1. Genetics
    • 2. Metabolic
    • 3. Microbiologic
    • 4. Immunologic
  208. Explain the wt loss in a pt with Type 1 DM
    • 1. the loss of body fluid
    • 2. in the absence of sufficient insulin the body begins to metabolize its own protein and fat.
  209. What is the cure for DM
    No Cure
  210. What is the goal for DM pt
    maintain blood glucose levels
  211. What is the number 1 tx for DM
    Insulin Therapy
  212. What is Type 2 Dm tx
    • Diet
    • Exercise
    • OHA's
    • Insulin
  213. Oral Hypoglycemic agents
    OHA's
  214. explain the precautions you take with NPH
    • Cloudy
    • Roll in hands
  215. Which routes can insulin be taken by
    • Injection
    • Inhaled
  216. Why can insulin not be taken by PO
    Gastric juices destroy it
  217. Are OHA's a form of insulin
    NO
  218. If your pt is taking an OHA should you advise them to stop their diet and exercise program
    NO
  219. Explain the cautions used with Lantix and Levomere
    Cant be mixed with anything
  220. Name 3 problems with Insulin Therapy
    • Allergic reaction
    • Lipodystrophy
    • Somogy Effect and Dawn phenomenon
  221. What should you do when taking Metgormin and need a contrast dye
    Hold metformin 48-72 hrs
  222. You have a pt that is presenting with symptoms of 3 P's, Flu like symptoms, Kussmauls Respirations, Fruity acetone breath, and dehydration. What do you expect the dr to dx this pt with
    Diabetic Ketoacidosis
  223. This is a serious condition caused by incomplete metabolism of fats due to the absence or insufficienty supply of insulin. The body breaks down protein and fat for energy. This produces an abundance of ketones
    Diabetic Ketoacidosis
  224. A pt presents with the following symptoms polyuria, lethargy, BS of 1,00-1,500 and no N & V. What would you expect the dr. to dx this pt with
    • HNKS
    • Hyperglycemic Hyperosmolar Nonketotic syndrome
  225. This occurs in type 2 DM who experience high blood glucose levels because of illness or added stress, such as infection.
    Hyperglycemic hyperosmolar nonketotic syndrome
  226. This is encountered with type 1 diabetes. This follows a period of hypoglycemia.
    Rebound Hyperglycemia
  227. this is characterized by elevated blood glucose in the morning, but is not related to hypoglycemia. This is caused by a release of GH, glucagons and epinephrine during the night. These are all counterregulatory hormones which act to raise the bodys blood sugar. This is why most DM can't tolerate carbs in the morning
    Dawn Phenomenon
  228. When does the Somogi Effect need to have BS checked
    Midnight
  229. Your pt presents with symptoms of tremulousness, hunger, headache, pallor, sweating, palpitations, blurred vision, weakness, confusion. You would expect the dr to dx this pt with
    Hypoglycemia
  230. This is a syndrome whereby a pt has insulin resistance, hypertension, increased LDLs and decreased HDLs.
    Insulin Resistence Syndrome
  231. Disease of the kidney occurs directly from changes in the renal blood circulation.
    nephropathy
  232. Very poor circulation in feet and lower extremities.
    peripheral vascular disease
  233. Visual impairment and blindness due to Dm
    Retinopathy
  234. The three most common visual disturbances
    • Diabetic Retinopathy
    • Cataracts
    • Glaucoma
  235. Pathologic changes in the NS causes deterioration of nerves
    neuropathy
  236. Your pt is presented with rapid heart beat, weakness, anxiety, nervousness, and hunger. What can you expect the dr to dx this pt with
    Hyperglycemia
  237. A pt recently diagnosed as having hypoglycemia says, "Hypoglycemia! I can't live with that. My neighbor had that and acted crazy!" Which of the following responses should you give him:

    A. hypoglycemia has been successfully tx by diet modifications
    B. You are right it would be difficult to live with hypoglycemia
    C. You seem to be overracting to the problem
    D. taking care of yourself years ago would have prevented this problem
    A. Hypoglycemia has been succussfully tx by diet modifications
    (this multiple choice question has been scrambled)
  238. DM is best defined as a (n):

    A. instability in glucogen stimulation
    B. disturbance in utilization of glucose
    C. inability of the body to maintain a normal metabolic rate
    D. dysfunction of the pancreas involving the absorption of proteins
    B. disturbance in utilization of glucose
    (this multiple choice question has been scrambled)
  239. Three of the following are early signs of hypoglycemia. Which one is not:

    A. hunger
    B. fluttering in the chest
    C. cool wet skin
    D. polyuria
    D. polyuria
    (this multiple choice question has been scrambled)
  240. When teaching a pt with type 1 diabetes about home care, you assure her that she can recognize the early signs of Diabetic Ketoacidosis, which are:

    A. thirst, dry mucous membranes, and dry skin
    B. cool, clammy skin
    C. hunger, headache, and tremulousness
    D. dark, scanty urine and diarrhea
    A. thirst dry mucous membranes and dry skin
    (this multiple choice question has been scrambled)
  241. When drawing up a long-acting insulin and regular insuling in one syringe, which of these actions should you take:

    A. draw up the regular acting insulin first
    B. draw up the smallest does of insulin first
    C. draw up the long-acting insulin first
    D. draw up the largest dose of insulin first
    A. draw up the reglular insulin first
    (this multiple choice question has been scrambled)
  242. Which of the following is most likely to occur if hypoglycemia is not tx properly?

    A. electrolyte imbalance
    B. loss of consciousness
    C. breakdown of protein for energy
    D. dehydration
    B. Loss of consciousness
    (this multiple choice question has been scrambled)
  243. A pt may be at risk for developing hyperglycemic hyperosmolar nonketotic syndrome if three of these conditions are present. Which condition is not considered a factor?

    A. drinking too much water
    B. taking steroids
    C. treatments with TPN
    D. having an infection
    A. drinking too much water
    (this multiple choice question has been scrambled)
  244. A pt with Dm has been maintained on Meformin (glucophage) for reglulation of her blood glucose levels. Which of the following issues should be included in this pt's teaching?

    A. report changes in voiding pattern
    B. use lotion to tx itching
    C. increase the amount of dietary carbs
    D. allow 6 weeks for optimal drug effectiveness
    A. report changes in voiding pattern
    (this multiple choice question has been scrambled)
  245. A pt with DM is taking Lantus insulin. The nurse is aware that this insulin will most likely be admin:

    A. prior to evening meal
    B. midday
    C. at night
    D. in the am
    C. at night
    (this multiple choice question has been scrambled)
  246. A pt presents in the ER with Polyuria, polydipsia, and polyphagia related to diabetes. You should expect these symptoms are related to :

    A. hyperthyroidism
    B. hyperglycemia
    C. hyperparathyroidism
    D. hypoglycemia
    B. hyperglycemia
    (this multiple choice question has been scrambled)
  247. A pt newly dx with DM is learning to admin his injections of NPH and regular insulin. Which statment indicates that the pt understands your teaching regarding proper insulin admin?

    a. I will give myself the NPH and regular in two different injections
    b. I will draw up the regular insulin before the NPH
    c. It doesn't matter what I draw up first as long as the dosage is correct
    d. I will draw up NPH before the Regular
    • B. I will draw up the regular before the NPH
    • CLEAR B4 CLOUDY
  248. THE FOLLOWING ARE ALL EXAMPLES OF
    Inhalation powder=Exubera
    Aspart Injection=NovoLog
    Lispro injection=Humalog
    Glulisine injection=Apidra
    Rapid Acting Insulin
  249. THE FOLLOWING ARE ALL EXAMPLES OF
    Regular human insulin injection=Humulin R
    Buffered regular human insulin injection= Velosulin BR
    Short acting Insulins
  250. THE FOLLOWING ARE ALL
    NPH
    Intermediate
  251. What does metformin have an effect on and what should you keep in mind
    Liver and No contrast dyes
  252. What are acarbose (precose)
    Startch blockers, Intestine
  253. pioglitazone (Actos) does what
    Decreases liver production of glucose, making muscle more sensitive to insulin
  254. What does Starlix and Prandin do
    stimulates insulin secretion Pancreas
  255. Januvia does what
    enhances natural body systems, regulates glucose Pancreas`

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