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dr_lawlz dr_lawlz
wrote...
Posts: 317
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6 years ago
Which information will the nurse teach a 48-year-old patient who has been newly diagnosed with Graves' disease?
 
  a. Exercise is contraindicated to avoid increasing metabolic rate.
  b. Restriction of iodine intake is needed to reduce thyroid activity.
  c. Antithyroid medications may take several months for full effect.
  d. Surgery will eventually be required to remove the thyroid gland.

Question 2

An expected nursing diagnosis for a 30-year-old patient admitted to the hospital with symptoms of diabetes insipidus is
 
  a. excess fluid volume related to intake greater than output.
  b. impaired gas exchange related to fluid retention in lungs.
  c. sleep pattern disturbance related to frequent waking to void.
  d. risk for impaired skin integrity related to generalized edema.

Question 3

A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)
 
  a. elevated hematocrit.
  b. decreased serum sodium.
  c. low urine specific gravity.
  d. increased serum chloride.

Question 4

The nurse determines that additional instruction is needed for a 60-year-old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient says which of the following?
 
  a. I need to shop for foods low in sodium and avoid adding salt to food.
  b. I should weigh myself daily and report any sudden weight loss or gain.
  c. I need to limit my fluid intake to no more than 1 quart of liquids a day.
  d. I will eat foods high in potassium because diuretics cause potassium loss.

Question 5

The nurse determines that demeclocycline (Declomycin) is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient's
 
  a. weight has increased.
  b. urinary output is increased.
  c. peripheral edema is decreased.
  d. urine specific gravity is increased.

Question 6

The nurse is assessing a 41-year-old African American male patient diagnosed with a pituitary tumor causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include
 
  a. high blood pressure.
  b. decreased facial hair.
  c. elevated blood glucose.
  d. tachycardia and cardiac palpitations.
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3 Replies

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Replies
wrote...
6 years ago
The answer to question 1

ANS: C
Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the full effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves' disease although surgery may be used.

The answer to question 2

ANS: C
Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema, excess fluid volume, and fluid retention are not expected.

The answer to question 3

ANS: B
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along with the sodium level.

The answer to question 4

ANS: A
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred.

The answer to question 5

ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and increases urine output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a common clinical manifestation of this disorder.

The answer to question 6

ANS: B
Changes in male secondary sex characteristics such as decreased facial hair, testicular atrophy, diminished spermatogenesis, loss of libido, impotence, and decreased muscle mass are associated with decreases in follicle stimulating hormone (FSH) and luteinizing hormone (LH). Fasting hypoglycemia and hypotension occur in panhypopituitarism as a result of decreases in adrenocorticotropic hormone (ACTH) and cortisol. Bradycardia is likely due to the decrease in thyroid stimulating hormone (TSH) and thyroid hormones associated with panhypopituitarism.
dr_lawlz Author
wrote...
6 years ago
Makes tons more sense now! Vote with confidence people, these are all correct
wrote...
6 years ago
Slight Smile Feeling super proud now
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