Course point- adrenal disorders

A client is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a client with this disorder?

Blood pressure varying between 120/86 and 240/130 mm Hg

The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following?

Hypotension

A 45-year-old client has been admitted to the hospital for a hypertensive crisis. The health care provider (HCP) has ruled out a cerebrovascular accident (CVA) but suspects pheochromocytoma. What additional signs and symptoms would further confirm this diagnosis as correct? Select all that apply.

hypermetabolism, hyperglycemia, hyperhidrosis

A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?

Monitor blood pressure (BP) frequently.

A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of:

Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the health care provider immediately?

An irregular apical pulse

A client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with:

depression

A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?

"I may stop taking this medication when I feel better."

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find:

deposits of adipose tissue in the trunk and dorsocervical area.

A client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:

serum glucose level.

A nurse should perform which intervention for a client with Cushing's syndrome?

Explain that the client's physical changes are a result of excessive corticosteroids.

A 35-year-old female client who reports weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by:

a corticotropin-secreting pituitary adenoma.

Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

Adrenal

Corticosteroids have which effect on wound healing?

Mask the presence of infection

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit?

moon face

A client has been diagnosed with Cushing's syndrome. The nurse would expect which of the following features to be present upon physical examination? Select all that apply.

"Buffalo hump", moon face, truncal obesity, purple straie

A client being treated for rheumatoid arthritis has been prescribed a glucocorticosteroid. How should the nurse best ensure this client's safety during treatment?

Ensure the client knows to taper down the dose if it is discontinued by the care provider.

The nurse teaches the client that corticosteroids will be used to treat their brain tumor to

reduce cerebral edema.

What should the nurse teach a client on corticosteroid therapy in order to reduce the client's risk of acute adrenal insufficiency?

Always have enough medication on hand to avoid running out.

A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?

adrenal insufficiency

What education should the nurse provide to the client taking long-term corticosteroids?

The client should not stop taking the medication abruptly and should be weaned off of the medication.

A client taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that they want to stop taking them because of the increase in acne and moon face. What can the nurse educate the client regarding these symptoms?

The moon face and acne will resolve when the medication is tapered off.

A nurse helps a client recently diagnosed with a pituitary adenoma understand that:

Most tumors produce too much of one or more hormones.

A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?

Cushing's disease

A nurse is caring for a client with Cushing's syndrome. Which interventions would the nurse include in the client's plan of care? Select all that apply.

Report systolic BP greater than 139 mm Hg or diastolic BP greater than 89 mm Hg. Examine extremities for pitting edema. Administer prescribed diuretics. Monitor weight.

A client diagnosed with Addisonian crisis has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?

IV corticosteroids

A client is being treated on the acute medical unit for acute pancreatitis. The nurse has identified an ineffective breathing pattern in the client related to pain. What intervention should the nurse perform to best address this?

Maintain the client in a semi-Fowler position whenever possible.

Which of the following hormones controls secretion of adrenal androgens?

Adrenocorticotropic hormone (ACTH)

Which condition is a sympathetic-adrenal medullary response to stress?

Increased heart rate

The calcium concentration in the blood is regulated by which mechanism?

Parathyroid hormone (PTH)

The home care nurse is conducting client teaching with a client on corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when should the home care nurse instruct the client to take the corticosteroids?

In the morning between 7 AM and 8 AM

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect:

a blood pressure of 176/88 mm Hg.

The nurse is aware that the best time of day for the total large corticosteroid dose is between:

7:00 AM and 8:00 AM

Which glands regulate calcium and phosphorous metabolism?

Parathyroid

Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

Cushing syndrome

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?

pituitary disorder

A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client?

Decreased blood pressure

The nurse is caring for a client with diabetes who has an infection. The nurse creates a plan of care for the client based on a knowledge of the hypothalamic-pituitary response to stress by including which nursing intervention in the plan of care?

Assessment for hyperglycemia

The nurse is caring for a client with Addison disease who is scheduled for discharge. When teaching the client about hormone replacement therapy, the nurse should address what topic?

The need for lifelong steroid replacement

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include

adrenal suppression.

During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently?

Assess vital signs.

What is the most common cause of hyperaldosteronism?

An adrenal adenoma

Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:

muscle weakness.

A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see?

Serum potassium level of 6.8 mEq/L

A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. The client's spouse reports that they acted confused and were extremely weak when they awoke that morning. The client's blood pressure is 90/58 mm Hg, their pulse is 116 beats/minute, and their temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion?

Hydrocortisone

Which hormone causes the kidneys to reabsorb sodium?

Aldosterone

A nurse is caring for a client in addisonian crisis. Which medication order should the nurse question?

Potassium chloride

Following an Addisonian crisis, a client's adrenal function has been gradually regained. The nurse should ensure that the client knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?

Episodes of high psychosocial stress

ADH is secreted by which gland?

Posterior pituitary

A client with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in the client's cortisol levels. How should the nurse interpret this finding?

The client's pituitary function is compromised.

The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension?

Pheochromocytoma

Which condition may occur during the postoperative period in a client who underwent adrenalectomy because of sudden withdraw of excessive amounts of catecholamines?

Hypoglycemia

Following a transsphenoidal hypophysectomy, a nurse should assess a client for which condition?

Hypocortisolism

A pheochromocytoma is a rare adrenal tumor that causes increased heart rate, blood pressure, and metabolism because of increased levels of circulating:

Catecholamines.

A client has been diagnosed with thrombocytopenia. What are the primary nursing interventions while instituting corticosteroid therapy in this client?

Gradually taper the dose and frequency of medication.

The nurse caring for a client with Cushing syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?

Administration of dexamethasone orally at night, followed by a plasma cortisol level the next morning