lewiss medical surgical nursing harding kwong hagl
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Test Bank For Lewiss Medical-Surgical Nursing, 12th Edition by
Mariann M. Harding, Jeffrey Kwong, Debra Hagler Chapter 1-
69 | 9780323789615 | All Chapters with Answers and
Rationals
When the nurse assesses the patient who has pancreatitis, what function may be altered related to
the endocrine function of the pancreas? - ANSWER: Blood glucose regulation
An elderly patient is seen in the endocrine clinic. Upon assessment, the nurse notes a palpable thyroid
gland. What does this finding indicate? - ANSWER: This is a normal finding in the elderly
A patient reports weight loss, increased appetite, chest pain, and hair loss. Assessment findings
include large and protruding eyes, skin that is warm, smooth, and moist, an elevated blood pressure,
and an increased heart rate. The nurse suspects that the patient has which condition? - ANSWER:
Hyperthyroidism
The nurse working in an endocrine clinic knows that Trousseau's sign is an important diagnostic tool.
Which statement best describes how to conduct the test for Trousseau's sign? - ANSWER: Inflate the
blood pressure cuff
A 22-year-old male patient states, "I am not able to grow a beard or mustache." The nurse recognizes
that which hormonal imbalance may lead to this type of problem? - ANSWER: Testosterone
The laboratory findings of a patient indicate decreased urine output. What condition does the nurse
suspect? - ANSWER: Syndrome of inapropriate antidiuretic hormone
Which hormone helps maintain water balance in a patient's body? - ANSWER: Antidiuretic hormone
A patient has sought care because of a loss of 25 lb over the past six months during which the patient
claims to have made no significant dietary changes. For what potential problem should the nurse
assess the patient? - ANSWER: Thyroid disorders
What is hypothyroidism and what causes it? - ANSWER: Hypothyroidism is insufficient circulating
thyroid hormone.
May be primary or secondary which is determined by the TSH level.
It can be caused by iodine deficiency, atrophy of the thyroid gland, treatment of hyperthyroidism
(RAI), or adverse drug effects (amiodrone and lithium)
What is primary and secondary hypothyroidism? - ANSWER: Primary: TSH is high. Related to
destruction of thyroid tissue or defective hormone synthesis
Secondary: TSH is low. Related to pituitary disease with decreased TSH or hypothalmic dysfunction
with decreased TRH
If someone has low TSH, they have what type of hypothyroidism? - ANSWER: Secondary, because the
pituitary or hypothalamus is not making enough TSH
What are the common clinical manifestations of hypothyroidism? - ANSWER: - Decreased rate and
force of contraction
- Decreased exercise tolerance
- Anemia, dyspnea
, - Decreased appetite, weight gain, constipation
- Dry, thick, inelastic skin
- Decreased sweating, pallor
- Fatigue, weakness, slow movements
- Apathy, lethargy, slow slurred speech
- Cold intolerance
- Goiter (seen in both hyper and hypo)
** Everything slows down **
What diagnostic studies confirm hypothyroidism? - ANSWER: - TSH to determine if it is primary or
secondary
- Free T4: decreased
- Increased cholesterol, triglycerides, creatine
- Presence of thyroi peroxidase
How do we treat hypothyroidism? - ANSWER: - We want to restore euthyroid state quickly and safely
- Low calorie diet to promote weight loss
- Leothyroxine (Synthyroid)
What is Leothyroxine (Synthyroid)? - ANSWER: - It is given to treat hypothyroidism
- In older adults and people with compromised cardiac status, we need to start this with a small dose
- This is a life long replacement therapy
- Leothyroxine effects anticoagulants and digitalis, therefor we need to be cautious and look for signs
of increased bleeding
A patient has hypothyroidism and understands the importance of having life long therapy with regular
follow ups. What type of signs and symptoms would be considered emergent and need immediate
contact with a doctor? - ANSWER: - Orthopnea and dyspnea
- Rapid pulse and palpitations
- Nervousness
- Insomnia
What is myxedema? - ANSWER: Myxedema develops in people with long standing hypothyroidism.
Includes features of dull, puffy skin, coarse, sparse hair, peri-orbital edema, and a prominent tongue
What is myxedema coma? - ANSWER: - Considered a medical emergency
- Mental sluggishness, drowsiness, noticeable decrease in LOC
- Precipitated by infections, drugs, exposure to cold, and trauma
- Characterized by a subnormal temperature, hypotension, and hypoventilation
In order for a patient to survive a myxedema coma, what must be done? - ANSWER: - Vital functions
must be supported )mechanical respiratory support, cardiac monitoring, monitor temp, monitor
progress)
- IV thyroid hormone replacement
What is Grave's diseases? - ANSWER: - Hyperthyroidism
- Autoimmune disease of unknown etiology marked by diffuse thyroid enlargement and excessive
thyroid secretion
- It may progress to complete destruction of thyroid tissue which may eventually cause
hypothyroidism
What are the precipitating factors to Grave's disease? - ANSWER: - Insufficient iodine supply
- Infection
- Stressful life events
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