Chapter 32: Endocrine Disorders and Therapeutic ManagementUrden: Critical Care Nursing, 8th Editio

Chapter 32: Endocrine Disorders and Therapeutic Management Urden: Critical Care Nursing, 8th Edition MULTIPLE CHOICE 1. The nurse is caring for a critically ill patient with type 1 diabetes. The nurse understands that the patient is at risk for developing diabetic ketoacidosis (DKA) secondary to what etiology? a. Excess insulin administration ha ve b. Inadequate food intake c. Physiologic and psychologic stress d. Increased release of antidiuretic hormone (ADH) ANS: C Major neurologic and endocrine changes occur when an individual is confronted with physiologic stress caused by any critical illness, sepsis, trauma, major surgery, or underlying cardiovascular disease. PTS: 1 DIF: Cognitive Level: Applying REF: p. 725 OBJ: Nursing Process Step: Diagnosis TOP: Endocrine MSC: NCLEX: Physiologic Integrity 2. The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS). Which findings would the nurse expect to observe in this patient? a. Hyperglycemia with low serum osmolality b. Severe hyperglycemia with minimal or absent ketosis c. Little or no ketosis in serum with rapidly escalating ketonuria d. Hyperglycemia and ketosis ANS: B The hallmarks of HHS are extremely high levels of plasma glucose with resulting elevations in serum hyperosmolality and osmotic diuresis. The disorder occurs mainly in patients with type 2 diabetes. PTS: 1 DIF: Cognitive Level: Applying REF: p. 743 OBJ: Nursing Process Step: Assessment TOP: Endocrine MSC: NCLEX: Physiologic Integrity 3. The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS). Which medical intervention would the nurse expect to see ordered for this patient? a. Rapid rehydration with intravenous fluids