NUR 352 Exam 4 Study Questions and Correct Answers
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Course
NUR 352
Institution
NUR 352
What are the clinical manifestations of diabetes insipidus? **characterized by lack of ADH**
- polyuria: increased output of very dilute urine w/ a specific gravity of 1.001 to 1.005, even without an increased fluid intake (leads to hypovolemia, dehydration)
- polydipsia: pts are extremely thirst...
NUR 352 Exam 4 Study Questions and
Correct Answers
What are the clinical manifestations of diabetes insipidus? ✅**characterized by lack of
ADH**
- polyuria: increased output of very dilute urine w/ a specific gravity of 1.001 to 1.005,
even without an increased fluid intake (leads to hypovolemia, dehydration)
- polydipsia: pts are extremely thirsty and drink 2-20 L of fluids/day; they often crave
cold water
When do symptoms appear for inherited diabetes insipidus? ✅possibly at birth; in
adults the onset may be insidious or abrupt
What should patients and families be taught about diabetes insipidus? ✅- how to
recognize the signs and symptoms of hyponatremia
- advise pt to wear a medical identification bracelet and to carry medication info about
this disorder at all times
What are the clinical manifestations of hypothyroidism? ✅- extreme fatigue
- hair loss
- brittle nails
- dry skin
- numbness/tingling in fingers
- husky voice and hoarseness
- menstrual disturbances (e.g. menorrhagia or amenorrhea)
- loss of libido
What are the clinical manifestations of severe hypothyroidism? ✅- subnormal temp
and pulse
- weight gain
- cachexia
- elevated serum cholesterol level
- atherosclerosis
- coronary artery disease
- poor left ventricle function
- thickened skin
- thinning hair or alopecia
- expressionless and masklike facial features
- sensation of being cold in a warm environment
- subdued emotional responses
- dulled mental processes and apathy
What are the clinical manifestations of advanced hypothyroidism? ✅- personality and
cognitive changes
- pleural effusion, pericardial effusion, and respiratory muscle weakness
- hypothermia
- abnormal sensitivity to sedatives, opiate drugs, and anesthetic agents (administer with
extreme caution)
Which medications need to be administered with extreme caution in pts with
hypothyroidism? ✅sedatives, opiate drugs, and anesthetic agents due to abnormal
sensitivity
What is an extreme but rare clinical manifestation of hypothyroidism? ✅myxedema
coma: initial signs of depression, diminished cognitive status, lethargy, and somnolence;
progression resulting in respiratory depression, hyponatremia, hypoglycemia,
hypoventilation, hypotension, bradycardia, and hypothermia
What should patients be taught about preventing medication interactions with thyroid
replacement hormones? ✅oral thyroid hormones interact w/ many meds:
- thyroid hormone absorption decreases when taking magnesium-containing antacids
- thyroid hormones increase blood sugar (may need adjusted doses of insulin or oral
hypoglycemic agents)
- thyroid hormone may increase the pharmacologic effect of anticoagulant meds
(warfarin)
What are the clinical manifestations of hyperthyroidism? ✅- enlarged thyroid gland
- nervousness (emotionally hyperexcitable)
- irritability
- apprehensiveness
- inability to sit quietly
- palpitations
- rapid pulse on rest and exertion
- poor tolerance of heat
- excessive perspiration
- skin that is flushed or salmon color and likely to be warm, soft, and moist
- dry skin and diffuse pruritus
- fine tremor of the hands
- exophthalmos (bulging eyes)
- increased appetite and dietary intake
- progressive loss of weight
- abnormal muscle fatigability
weakness
, - amenorrhea
changes in bowel function (diarrhea)
What effects does hyperthyroidism have on the heart? ✅may cause atrial fibrillation,
sinus tachycardia or dysrhythmias, increased pulse pressure, and palpitations,
myocardial hypertrophy and heart failure
How can the nurse improve nutritional status in patients with hyperthyroidism? ✅-
provide several small, well-balanced meals (up to six meals a day) to satisfy their
increased appetite
- replace food and fluids lost due to diarrhea and diaphoresis and control diarrhea that
results from increased peristalsis
- reduce diarrhea (avoid highly seasoned foods and stimulants like coffee, tea, cola, and
alcohol)
- encourage high-calorie, high-protein foods
- provide quiet atmosphere during mealtime to aid digestion
- record weight and dietary intake daily
How can the nurse enhance coping measures in pts with hyperthyroidism? ✅-
reassure the pt that the emotional reactions being experienced are a result of the
disorder and that, with effective treatment, those symptoms will be controlled
- reassure family and friends that symptoms are expected to disappear with treatment
- maintain a calm, unhurried approach and minimize stressful experiences
- quiet and uncluttered environment
- provide info regarding thyroidectomy and preparatory pharmacotherapy to alleviate
anxiety
- assist pt to take meds as prescribed and encourage adherence to the therapeutic
regimen
- repeat info often and provide written instructions as indicated due to short attention
span
How can the nurse maintain normal body temperature in pts with hyperthyroidism? ✅-
provide a cool, comfortable environment and fresh bedding and gown as needed
- give cool baths and provide cool fluids
- monitor body temperature
How can the nurse monitor and manage potential complications of hyperthyroidism?
✅- monitor closely for s/s of thyroid storm - assess cardiac and respiratory function:
vital signs, cardiac output, ECG monitoring, ABG, pulse oximetry
- monitor for signs of heart failure
- give o2 to prevent hypoxia, to improve tissue oxygenation, and to meet the high
metabolic demands
- give IV fluids to maintain blood glucose levels and replace lost fluids
- administer antithyroid meds to reduce thyroid hormone levels
- administer propranolol to treat cardiac symptoms
- monitor for hypothyroidism
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