Lewis MED-SURG_ Chapter 50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
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50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine Problems – lecture summary.pdf
Lewis MED-SURG:
Chapter 50
Endocrine
Problems – lecture
summary
Lewis MED-SURG_ Chapter 50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine Problems – lecture summary.pdf
,Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
A patient suspected of having acromegaly has an d. A normal response to growth hormone (GH) secretion
elevated plasma growth hormone (GH) level. In is stimulation of the liver to produce somatomedin C, or insulin-like growth factor-1
acromegaly, what would the nurse also expect the (IGF-1), which stimulates growth of bones and soft tissues. The increased levels of
patient's diagnostic results to indicate? a. somatomedin C normally inhibit GH but in acromegaly
Hyperinsulinemia b. Plasma glucose of <70 mg/dL (3.9 the pituitary gland secretes GH despite elevated IGF-1
mmol/L) levels. When both GH and IGF-1 levels are increased, overproduction of GH is
c. Decreased GH levels with an oral glucose challenge confirmed. GH also causes elevation of blood glucose and normally GH levels fall
test d. Elevated levels of plasma insulin-like growth factor- during an oral glucose challenge but not in acromegaly.
1 (IGF-1)
During assessment of the patient with acromegaly, what c. The increased production of GH in acromegaly causes an increase in thickness
should the nurse expect the patient to report? and width of bones and enlargement of soft tissues, resulting in marked changes in
a. Infertility b. Dry, irritated skin m facial features, oily and coarse skin, and speech difficulties. Infertility
c. Undesirable changes in appearance is not a common finding because GH is usually the only pituitary hormone involved
d. An increase in height of 2 to 3 inches a year in acromegaly. Height is not increased in adults with GH excess because the
epiphyses of the bones are closed.
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
,Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
A patient with acromegaly is treated with a a. A transsphenoidal hypophysectomy involves entry into the sella turcica through
transsphenoidal hypophysectomy. What should the nurse an incision in the upper lip and gingiva into the floor of the nose and the sphenoid
do postoperatively? sinuses. Postoperative clear nasal drainage with glucose content indicates
a. Ensure that any clear nasal drainage is tested for cerebrospinal fluid (CSF) leakage from an open connection to the brain, putting
glucose. b. Maintain the patient flat in bed to prevent the patient at risk for meningitis. After surgery, the patient is positioned with the
cerebrospinal fluid (CSF) leakage. head elevated to avoid pressure on the sella turcica. Coughing and straining are
c. Assist the patient with toothbrushing every 4 hours to avoided to prevent increased intracranial pressure and CSF leakage. Although
keep the surgical area clean. mouth care is required every 4 hours, toothbrushing should not be performed
d. Encourage deep breathing, coughing, and turning to because injury to the suture line may occur.
prevent respiratory complications.
What findings are commonly found in a patient with a d. Compression of the optic chiasm can cause visual problems as well as signs of
prolactinoma? increased intracranial pressure, including headache, nausea, and vomiting. About
a. Gynecomastia in men b. Profuse menstruation in 30% of prolactinomas will have excess prolactin secretion with manifestations of
women c. Excess follicle-stimulating hormone (FSH) and impotence in men, galactorrhea or amenorrhea in women without relationship to
luteinizing hormone (LH) d. Signs of increased intracranial pregnancy, and decreased libido in both men and women. There is decreased
pressure, including headache, nausea, and vomiting follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
An African American woman with a history of breast a, b, d, e. With panhypopituitarism, lifetime hormone replacement is needed for
cancer has panhypopituitarism from radiation therapy for cortisol, vasopressin, thyroid, and GH. Sex hormones will not be replaced because
primary pituitary tumors. Which medications should the of the patient's history of breast cancer. Dopamine agonists will not be used
nurse teach her about needing for the rest of her life because they reduce secretion of GH, which has already been achieved with the
(select all that apply)? a. Cortisol b. Vasopressin c. Sex radiation.
hormones d. Levothyroxine (Synthroid) e. Growth
hormone (somatropin [Omnitrope]) f. Dopamine agonists
(bromocriptine [Parlodel])
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
, Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
The patient is diagnosed with syndrome of inappropriate b. With increased antidiuretic hormone (ADH), the permeability of the renal distal
antidiuretic hormone (SIADH). What manifestation should tubules is increased, so water is reabsorbed into circulation. Decreased output of
the nurse expect to find? a. Decreased body weight c. concentrated urine with increased urine osmolality and specific gravity occur. In
Increased plasma osmolality b. Decreased urinary output addition, fluid retention with weight gain, serum hypoosmolality, dilutional
d. Increased serum sodium levels hyponatremia, and hypochloremia occur.
During care of the patient with SIADH, what should the a. The patient with syndrome of inappropriate antidiuretic hormone (SIADH) has
nurse do? marked dilutional hyponatremia
a. Monitor neurologic status at least every 2 hours. b. and should be monitored for decreased neurologic function and seizures every 2
Teach the patient receiving treatment with diuretics to hours. Sodium intake is supplemented because of the hyponatremia and sodium
restrict sodium intake. loss caused by diuretics. ADH release is reduced by keeping the head of the bed
c. Keep the head of the bed elevated to prevent flat to increase left atrial filling pressure. A reduction
antidiuretic hormone (ADH) release. d. Notify the health in blood pressure (BP) indicates a reduction in total fluid
care provider if the patient's blood pressure decreases volume and is an expected outcome of treatment.
more than 20 mm Hg from baseline.
A patient with SIADH is treated with water restriction. b. The patient with SIADH has water retention with
What does the patient experience when the nurse hyponatremia, decreased urine output, and concentrated urine with high specific
determines that treatment has been effective? a. gravity. Improvement in the patient's condition is reflected by increased urine
Increased urine output, decreased serum sodium, and output, normalization of serum sodium, and more water in the urine, thus
increased urine specific gravity b. Increased urine output, decreasing the specific gravity.
increased serum sodium, and decreased urine specific
gravity c. Decreased urine output, increased serum
sodium, and decreased urine specific gravity d.
Decreased urine output, decreased serum sodium, and
increased urine specific gravity
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine Problems – lecture summary.pdf
Lewis MED-SURG:
Chapter 50
Endocrine
Problems – lecture
summary
Lewis MED-SURG_ Chapter 50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine
LewisProblems
MED-SURG_
– lecture
Chapter
summary.pdf
50 Endocrine Problems – lecture summary.pdf
,Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
A patient suspected of having acromegaly has an d. A normal response to growth hormone (GH) secretion
elevated plasma growth hormone (GH) level. In is stimulation of the liver to produce somatomedin C, or insulin-like growth factor-1
acromegaly, what would the nurse also expect the (IGF-1), which stimulates growth of bones and soft tissues. The increased levels of
patient's diagnostic results to indicate? a. somatomedin C normally inhibit GH but in acromegaly
Hyperinsulinemia b. Plasma glucose of <70 mg/dL (3.9 the pituitary gland secretes GH despite elevated IGF-1
mmol/L) levels. When both GH and IGF-1 levels are increased, overproduction of GH is
c. Decreased GH levels with an oral glucose challenge confirmed. GH also causes elevation of blood glucose and normally GH levels fall
test d. Elevated levels of plasma insulin-like growth factor- during an oral glucose challenge but not in acromegaly.
1 (IGF-1)
During assessment of the patient with acromegaly, what c. The increased production of GH in acromegaly causes an increase in thickness
should the nurse expect the patient to report? and width of bones and enlargement of soft tissues, resulting in marked changes in
a. Infertility b. Dry, irritated skin m facial features, oily and coarse skin, and speech difficulties. Infertility
c. Undesirable changes in appearance is not a common finding because GH is usually the only pituitary hormone involved
d. An increase in height of 2 to 3 inches a year in acromegaly. Height is not increased in adults with GH excess because the
epiphyses of the bones are closed.
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
,Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
A patient with acromegaly is treated with a a. A transsphenoidal hypophysectomy involves entry into the sella turcica through
transsphenoidal hypophysectomy. What should the nurse an incision in the upper lip and gingiva into the floor of the nose and the sphenoid
do postoperatively? sinuses. Postoperative clear nasal drainage with glucose content indicates
a. Ensure that any clear nasal drainage is tested for cerebrospinal fluid (CSF) leakage from an open connection to the brain, putting
glucose. b. Maintain the patient flat in bed to prevent the patient at risk for meningitis. After surgery, the patient is positioned with the
cerebrospinal fluid (CSF) leakage. head elevated to avoid pressure on the sella turcica. Coughing and straining are
c. Assist the patient with toothbrushing every 4 hours to avoided to prevent increased intracranial pressure and CSF leakage. Although
keep the surgical area clean. mouth care is required every 4 hours, toothbrushing should not be performed
d. Encourage deep breathing, coughing, and turning to because injury to the suture line may occur.
prevent respiratory complications.
What findings are commonly found in a patient with a d. Compression of the optic chiasm can cause visual problems as well as signs of
prolactinoma? increased intracranial pressure, including headache, nausea, and vomiting. About
a. Gynecomastia in men b. Profuse menstruation in 30% of prolactinomas will have excess prolactin secretion with manifestations of
women c. Excess follicle-stimulating hormone (FSH) and impotence in men, galactorrhea or amenorrhea in women without relationship to
luteinizing hormone (LH) d. Signs of increased intracranial pregnancy, and decreased libido in both men and women. There is decreased
pressure, including headache, nausea, and vomiting follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
An African American woman with a history of breast a, b, d, e. With panhypopituitarism, lifetime hormone replacement is needed for
cancer has panhypopituitarism from radiation therapy for cortisol, vasopressin, thyroid, and GH. Sex hormones will not be replaced because
primary pituitary tumors. Which medications should the of the patient's history of breast cancer. Dopamine agonists will not be used
nurse teach her about needing for the rest of her life because they reduce secretion of GH, which has already been achieved with the
(select all that apply)? a. Cortisol b. Vasopressin c. Sex radiation.
hormones d. Levothyroxine (Synthroid) e. Growth
hormone (somatropin [Omnitrope]) f. Dopamine agonists
(bromocriptine [Parlodel])
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
, Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
The patient is diagnosed with syndrome of inappropriate b. With increased antidiuretic hormone (ADH), the permeability of the renal distal
antidiuretic hormone (SIADH). What manifestation should tubules is increased, so water is reabsorbed into circulation. Decreased output of
the nurse expect to find? a. Decreased body weight c. concentrated urine with increased urine osmolality and specific gravity occur. In
Increased plasma osmolality b. Decreased urinary output addition, fluid retention with weight gain, serum hypoosmolality, dilutional
d. Increased serum sodium levels hyponatremia, and hypochloremia occur.
During care of the patient with SIADH, what should the a. The patient with syndrome of inappropriate antidiuretic hormone (SIADH) has
nurse do? marked dilutional hyponatremia
a. Monitor neurologic status at least every 2 hours. b. and should be monitored for decreased neurologic function and seizures every 2
Teach the patient receiving treatment with diuretics to hours. Sodium intake is supplemented because of the hyponatremia and sodium
restrict sodium intake. loss caused by diuretics. ADH release is reduced by keeping the head of the bed
c. Keep the head of the bed elevated to prevent flat to increase left atrial filling pressure. A reduction
antidiuretic hormone (ADH) release. d. Notify the health in blood pressure (BP) indicates a reduction in total fluid
care provider if the patient's blood pressure decreases volume and is an expected outcome of treatment.
more than 20 mm Hg from baseline.
A patient with SIADH is treated with water restriction. b. The patient with SIADH has water retention with
What does the patient experience when the nurse hyponatremia, decreased urine output, and concentrated urine with high specific
determines that treatment has been effective? a. gravity. Improvement in the patient's condition is reflected by increased urine
Increased urine output, decreased serum sodium, and output, normalization of serum sodium, and more water in the urine, thus
increased urine specific gravity b. Increased urine output, decreasing the specific gravity.
increased serum sodium, and decreased urine specific
gravity c. Decreased urine output, increased serum
sodium, and decreased urine specific gravity d.
Decreased urine output, decreased serum sodium, and
increased urine specific gravity
Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf Lewis_ MED-SURG_ Chapter 50_ Endocrine Problems.pdf
