Chapter 50: Nursing Management:
Endocrine Problems
A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis,
which question should the nurse ask?
a.
Have you had a recent head injury?
b.
Do you have to wear larger shoes now?
c.
Are you experiencing tremors or anxiety?
d.
Is there any family history of acromegaly? - correct answer-ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family history are
not risk factors for acromegaly. Tremors and anxiety are not clinical manifestations of
acromegaly.
During preoperative teaching for a patient scheduled for transsphenoidal hypophysectomy
for treatment of a pituitary adenoma, the nurse instructs the patient about the need to
a.
cough and deep breathe every 2 hours postoperatively.
b.
remain on bed rest for the first 48 hours after the surgery.
c.
be positioned flat with sandbags at the head postoperatively.
d.
avoid brushing the teeth for at least 10 days after the surgery. - correct answer-ANS: D
To avoid disruption of the suture line, the patient should avoid brushing the teeth for 10 days
after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is
discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line.
The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica
and decrease the risk for headaches.
Which nursing action will be included in the postoperative plan of care for a patient who has
had a transsphenoidal resection of a pituitary tumor?
a.
Monitor urine output every hour.
b.
Palpate extremities for dependent edema.
c.
Check hematocrit hourly for first 12 hours.
d.
Obtain continuous pulse oximetry for 24 hours. - correct answer-ANS: A
After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral edema
and monitoring of urine output and urine specific gravity is essential. Hemorrhage is not a
, common problem. There is no need to check the hematocrit hourly. The patient is at risk for
dehydration, not volume overload. The patient is not at high risk for problems with
oxygenation, and continuous pulse oximetry is not needed.
A patient is suspected of having a pituitary tumor causing panhypopituitarism. During
assessment of the patient, the nurse would expect to find
a.
high blood pressure.
b.
elevated blood glucose.
c.
tachycardia and cardiac palpitations.
d.
changes in secondary sex characteristics. - correct answer-ANS: D
Changes in secondary sex characteristics 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.
Which information will the nurse include when teaching a patient about use of somatropin
(Genotropin)?
a.
The medication will improve vaginal dryness.
b.
Inject the medication subcutaneously every day.
c.
Blood glucose levels will decrease when taking the medication.
d.
Stop taking the medication if swelling of the hands or feet occurs. - correct answer-ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other adverse effects occur,
the health care provider should be notified. Growth hormone will increase blood glucose
levels.
A patient is treated with demeclocycline (Declomycin) to control the symptoms of syndrome
of inappropriate antidiuretic hormone (SIADH). The nurse determines that the
demeclocycline is effective upon finding that the
a.
peripheral edema is decreased.
b.
patients weight has increased.
c.
urine specific gravity is increased.
d.
patients urinary output is increased. - correct answer-ANS: D
Demeclocycline blocks the action of 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
Endocrine Problems
A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis,
which question should the nurse ask?
a.
Have you had a recent head injury?
b.
Do you have to wear larger shoes now?
c.
Are you experiencing tremors or anxiety?
d.
Is there any family history of acromegaly? - correct answer-ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family history are
not risk factors for acromegaly. Tremors and anxiety are not clinical manifestations of
acromegaly.
During preoperative teaching for a patient scheduled for transsphenoidal hypophysectomy
for treatment of a pituitary adenoma, the nurse instructs the patient about the need to
a.
cough and deep breathe every 2 hours postoperatively.
b.
remain on bed rest for the first 48 hours after the surgery.
c.
be positioned flat with sandbags at the head postoperatively.
d.
avoid brushing the teeth for at least 10 days after the surgery. - correct answer-ANS: D
To avoid disruption of the suture line, the patient should avoid brushing the teeth for 10 days
after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is
discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line.
The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica
and decrease the risk for headaches.
Which nursing action will be included in the postoperative plan of care for a patient who has
had a transsphenoidal resection of a pituitary tumor?
a.
Monitor urine output every hour.
b.
Palpate extremities for dependent edema.
c.
Check hematocrit hourly for first 12 hours.
d.
Obtain continuous pulse oximetry for 24 hours. - correct answer-ANS: A
After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral edema
and monitoring of urine output and urine specific gravity is essential. Hemorrhage is not a
, common problem. There is no need to check the hematocrit hourly. The patient is at risk for
dehydration, not volume overload. The patient is not at high risk for problems with
oxygenation, and continuous pulse oximetry is not needed.
A patient is suspected of having a pituitary tumor causing panhypopituitarism. During
assessment of the patient, the nurse would expect to find
a.
high blood pressure.
b.
elevated blood glucose.
c.
tachycardia and cardiac palpitations.
d.
changes in secondary sex characteristics. - correct answer-ANS: D
Changes in secondary sex characteristics 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.
Which information will the nurse include when teaching a patient about use of somatropin
(Genotropin)?
a.
The medication will improve vaginal dryness.
b.
Inject the medication subcutaneously every day.
c.
Blood glucose levels will decrease when taking the medication.
d.
Stop taking the medication if swelling of the hands or feet occurs. - correct answer-ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other adverse effects occur,
the health care provider should be notified. Growth hormone will increase blood glucose
levels.
A patient is treated with demeclocycline (Declomycin) to control the symptoms of syndrome
of inappropriate antidiuretic hormone (SIADH). The nurse determines that the
demeclocycline is effective upon finding that the
a.
peripheral edema is decreased.
b.
patients weight has increased.
c.
urine specific gravity is increased.
d.
patients urinary output is increased. - correct answer-ANS: D
Demeclocycline blocks the action of 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
