MARYVILLE NURS 623 EXAM 2 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTION. Graded A+

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MARYVILLE NURS 623 EXAM 2 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTION Which of the serum laboratory findings are present in the client with Cushing's syndrome? Correct Answer- Increased cortisol, ... HYPERnatremia, and HYPOkalemia Alice, age 48, has a benign thyroid nodule. The most common treatment involves: Correct AnswerWatchful waiting with an annual follow-up ACE inhibitors are given to clients with diabetes who have Correct Answer- 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? Correct Answer- metformin An elderly client with hyperthyroidism may present with atypical symptoms. Which of the following manifestations are commonly seen in the elderly with hyperthyroidism? Correct Answer- 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? Correct Answer- 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? Correct Answer- 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? Correct Answer- "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? Correct Answerparathyroidectomy The most common worldwide cause of hypothyroidism is: Correct Answer- iodine deficiency What should be assessed for during exam on pt with HYPOparathyroidism? Correct Answer- 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 Correct Answer- ADD LONG-ACTING INSULIN Joy has gout. In teaching her about her disease, which food do you tell her is allowed in her diet? Correct Answer- Broccoli What controls the amount of calcium in the blood? Correct Answer- Parathyroid Thyroid hormones regulate Correct Answer- metabolism Which tests should you order to confirm a diagnosis of hypothyroidism? Correct Answer- t3 & Free T4 (preferred over T4) What are the hallmark signs of Grave's disease? Correct Answer- enlarged thyroid and increased T3 What is the gold standard screening for thyroid TUMOR/NODULE? Correct Answer- ULTRASOUND What is the diagnostic screening for thyroid cancer? Correct Answer- FINE NEEDLE BIOPSY What is the preferred treatment of Grave's disease in pregnancy Correct Answer- Propylthiouracil (PTU): Before starting anti-thyroid meds what should be checked? Correct Answer- LIVER FUNCTIONSwhat is the goal of thyroid treatment Correct Answer- euthyroid state What are signs and symptoms of hypothyroidism overtreatment? Correct Answer- hyperglycemia; cardiac arrhythmias (Afib); adrenal insufficiency; increased myxedema. Hyperthyroidism causes an excessive secretion of which thyroid hormones? Correct Answer- T3 & T4 What are S/S of hyperthyroidism? Correct Answer- "Hot/buldging/fast" heat intolerance, eye buldge, tachycardia, weight loss, diarrhea, systolic HTN, enlarged thyroid What are S/S of HYPOthyroidism? Correct Answer- "cold, slow, tired" cold intolerance, slow speech, fatigue, lethargy, weight gain, constipation, brittle nail/hair What is the most common cause of hyperthyroidism? Correct Answer- Graves disease Name the two thyroid hormones produced by the thyroid gland? Correct Answer- T3 & T4 Name the hormone produced by the pituitary gland, state the purpose of the hormone Correct AnswerTSH; regulate the production of hormones by the thyroid gland IN GRAVES DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE __________ Correct Answer- LOW; HIGH IN HASHIMOTO'S DISEASE THE THE TSH IS _________ AND THE T3/T4 ARE __________ Correct AnswerHIGH; LOW WHAT allows the resolution of hyperthyroidism, although patients then become hypothyroid and require thyroid replacement therapy for life Correct Answer- ABLATIVE DOSE IODINE According to the American Association of Clinical Endocrinologists, the usual dose of levothyroxine per day for full replacement? Correct Answer- 1.6 mcg/kg per day 50-100 MCG DAYwhat pt education do you give with levothyroxine? Correct Answer- take meds on empty stomach 30 mins before morning meal (may cause insomnia if taken at night) How would you alter the dose for initiating synthetic thyroid replacement with an older patient with hx of cardiac issues? Correct Answer- Begin with one-half of the expected replacement dose or 25 to50 mcg/day PO, increasing the dose gradually by 25 mcg/day once every 4 to 6 weeks; cardiac start at 12.5 mcg/day What is the long standing effects of HYPERthyroidism? Correct Answer- OSTEOPOROSIS CONSIDER BONE DENSITY TESTING, VIT D, & CALCIUM SUPPLEMENTS IN OLDER PT How long will the patient require thyroid replacement therapy after ablative radioactive treatment for hyperthyroidism? Correct Answer- FOR LIFE Which treatment FOR hyperthyroidism is recommended for middle age and older adults? Correct Answer- Radioactive iodine 131 WHAT works by inhibiting thyroid hormone synthesis at multiple steps. They are used as a treatment to reduce the level of hormone on initiation of radioactive iodine therapy,( not used as primary or sole treatment) Correct Answer- ANTI-THYROID MED (Propylthiouracil (PTU) Methimazole (MMI) What should those treated with radioactive die be aware of? Correct Answer- AVOID CONTACT WITH INFANTS, CHILDREN, AND PREGNANT WOMEN FOR 7 DAYS What is the test that assesses the functional status (hot and cold spots) of the thyroid gland to differentiate between Grave's disease and subacute thyroiditis and toxic nodular goiters? Correct Answer- RADIO IODINE UPTAKE SCAN What is the gold standard test for confirming Hashimoto's? Correct Answer [Show More]

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