NSG 4100 BARBIES QUESTIONS AND ANSWERS A+
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Clinical Manifestations of adrenal hyperplasia
Visualization! Can usually see right away.
masculine feature in women- masculine placement of pubic hair, beard, baldness,
masculine build
What signs and symptoms might someone report with suspected Adrenal
Hyperplasia?
Extreme fatigue, weight loss, decreased appetite, Darkening of skin, Low BP, Low
Blood Sugar, Nausea & Vomiting, Abdominal Pain
A patient is prescribed corticosteroid therapy for their new diagnosis of adrenal
hyperplasia. What are important teachings related to their therapy?
Need to know what are complications of lifelong corticosteroids
- Cardiovascular: HTN, thrombophlebitis,
thromboembolism, and accelerated atherosclerosis
- Immunological: Increased risk of infections
- Ophthalmic: Glaucoma and corneal lesion
They will also develop photosensitivity.
A patient on prednisone states "I can stop taking this medication whenever I feel
my Adrenal Hyperplasia symptoms have subsided." Should they be corrected?
Yes, correct them.
You can not suddenly stop corticosteroid therapy, they must be weaned off.
A patient has been taking prednisone for two days. They come into the ED
confused, BP 78/36, and have nausea and vomiting. What is the priority? What
would you do after that?
Administer Hydrocortisone IV (Solu-Cortef).
Follow this medication with 5% Dextrose in 0.9% saline.
Which client is most at risk for entering a hyperglycemic-hyperosmolar state?
Type II Diabetics
A patient enter the ED with BG of 680. Which question should you ask the client
to determine the cause of the acute complication?
Have you had some sort of infection lately?
A patient is admitted to the ED with low potassium and high sodium levels. The
patient is also frequently urinating. What is suspected and what is the priority?
, Diabetes Insipidus
Place patient on cardiac monitoring
What is normal serum osmolarity?
What is the expected osmolarity for a patient with HHS?
Normal: 275 to 295 mOsm/kg
HHS: 320-400 mOsm/kg
A patient comes into the ED with extreme thirst, polyuria and a history of
diabetes. Their blood sugar comes back at 685. What do you anticipate will be
prescribed? What is important to know about this medication?
Regular insulin IV.
Regular insulin is the only type of insulin to be given IV.
A patient in DKA has family in the room. The family is concerned about the
client's confusion and drowsiness. What should you state to the client's family?
The client's LOC should improve once electrolytes and oxygen status improve.
You are educating a patient with type one diabetes about preventing DKA. What
should you tell the client?
Take your prescribed insulin even when unable to eat due to illness. (bc sickness
causes high BS)
How often should a patient with DM see their eye doctor?
At least once a year.
Who is at risk for developing Cushing's Syndrome? Why?
Someone with emphysema because of their long-term steroid usage they cortisol levels
are decreased.
Cortisol levels are higher in the morning or night?
Levels are higher in the morning
The pituitary released _____ which stimulates the ______ glands to release
cortisol.
ACTH
Adrenal
Patients which congenital adrenal hyperplasia are at risk for ______ due to their
low cortisol levels.
Adrenal/Addisonian Crisis
A patient diabetes insipidus can develop high levels of sodium and low levels of
___________. When this happens what medication do you expected to
administer?
Potassium
Spironolactone
A patient is post-op adrenalectomy. Which finding requires immediate follow-up
by the nurse?
Restlessness
A patient with Cushings needs work out 3x a week with high intensity sessions.
True
False
False
A patient is post-op transsphenoidal hypophysectomy. What would a patient
state that would alarm you to a serious post-op complication?
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Clinical Manifestations of adrenal hyperplasia
Visualization! Can usually see right away.
masculine feature in women- masculine placement of pubic hair, beard, baldness,
masculine build
What signs and symptoms might someone report with suspected Adrenal
Hyperplasia?
Extreme fatigue, weight loss, decreased appetite, Darkening of skin, Low BP, Low
Blood Sugar, Nausea & Vomiting, Abdominal Pain
A patient is prescribed corticosteroid therapy for their new diagnosis of adrenal
hyperplasia. What are important teachings related to their therapy?
Need to know what are complications of lifelong corticosteroids
- Cardiovascular: HTN, thrombophlebitis,
thromboembolism, and accelerated atherosclerosis
- Immunological: Increased risk of infections
- Ophthalmic: Glaucoma and corneal lesion
They will also develop photosensitivity.
A patient on prednisone states "I can stop taking this medication whenever I feel
my Adrenal Hyperplasia symptoms have subsided." Should they be corrected?
Yes, correct them.
You can not suddenly stop corticosteroid therapy, they must be weaned off.
A patient has been taking prednisone for two days. They come into the ED
confused, BP 78/36, and have nausea and vomiting. What is the priority? What
would you do after that?
Administer Hydrocortisone IV (Solu-Cortef).
Follow this medication with 5% Dextrose in 0.9% saline.
Which client is most at risk for entering a hyperglycemic-hyperosmolar state?
Type II Diabetics
A patient enter the ED with BG of 680. Which question should you ask the client
to determine the cause of the acute complication?
Have you had some sort of infection lately?
A patient is admitted to the ED with low potassium and high sodium levels. The
patient is also frequently urinating. What is suspected and what is the priority?
, Diabetes Insipidus
Place patient on cardiac monitoring
What is normal serum osmolarity?
What is the expected osmolarity for a patient with HHS?
Normal: 275 to 295 mOsm/kg
HHS: 320-400 mOsm/kg
A patient comes into the ED with extreme thirst, polyuria and a history of
diabetes. Their blood sugar comes back at 685. What do you anticipate will be
prescribed? What is important to know about this medication?
Regular insulin IV.
Regular insulin is the only type of insulin to be given IV.
A patient in DKA has family in the room. The family is concerned about the
client's confusion and drowsiness. What should you state to the client's family?
The client's LOC should improve once electrolytes and oxygen status improve.
You are educating a patient with type one diabetes about preventing DKA. What
should you tell the client?
Take your prescribed insulin even when unable to eat due to illness. (bc sickness
causes high BS)
How often should a patient with DM see their eye doctor?
At least once a year.
Who is at risk for developing Cushing's Syndrome? Why?
Someone with emphysema because of their long-term steroid usage they cortisol levels
are decreased.
Cortisol levels are higher in the morning or night?
Levels are higher in the morning
The pituitary released _____ which stimulates the ______ glands to release
cortisol.
ACTH
Adrenal
Patients which congenital adrenal hyperplasia are at risk for ______ due to their
low cortisol levels.
Adrenal/Addisonian Crisis
A patient diabetes insipidus can develop high levels of sodium and low levels of
___________. When this happens what medication do you expected to
administer?
Potassium
Spironolactone
A patient is post-op adrenalectomy. Which finding requires immediate follow-up
by the nurse?
Restlessness
A patient with Cushings needs work out 3x a week with high intensity sessions.
True
False
False
A patient is post-op transsphenoidal hypophysectomy. What would a patient
state that would alarm you to a serious post-op complication?
