ECCO Endocrine Disorders SOLUTIONS 100% CORRECT ANSWERS

ECCO Endocrine Disorders SOLUTIONS 100% CORRECT ANSWERS A patient taking tricyclic antidepressants is admitted after a CABG; UO was low in surgery. After anesthesia reversal, the patient is very lethargic. Administration of which should the nurse anticipate? - ANSWER 3% saline A patient with TBI is lethargic with poor skin turgor. Which should the nurse anticipate? - ANSWER Desmopressin and vasopressin A patient with history of osteoporosis and bone pain is admitted with symptomatic bradycardia and reports recent onset of forgetfulness, loss of appetite, and depression; Ca++ 14.5. Administration of which should the nurse anticipate? - ANSWER isotonic fluids and lasix A patient with bronchogenic carcinoma is admitted with lethargy and confusion. Serum sodium is 118. Which intervention should the nurse anticipate? - ANSWER Na increase by 0.5 mEq/L/hr with hypertonic saline solution Which of the following interventions in a critically ill patient can contribute to insulin resistance? - ANSWER Epinephrine infusion What priority intervention is essential for managing a patient with DI? - ANSWER Infusing IV hypotonic fluids Following a patient's carotid artery surgery, the nurse observes new-onset atrial fibrillation, HR 155, BP 148/92, temp 38.6, RR 24, and TSH 0.04. The nurse should expect administration of which to control the atrial fibrillation? - ANSWER Beta blockers or calcium channel blockers A 75-year-old patient admitted from a chronic care facility with HHS is semi-comatose with severe dehydration. Fluids and IV regular insulin 0.1 units/kg/hr? - ANSWER Blood glucose 285 mg/dL A patient with a history of diabetes is treated for DKA. The patient is receiving a continuous infusion of IV insulin. The presence of which criteria indicates the patient can be changed to subQ insulin? - ANSWER Blood glucose 198, pH 7.35, anion gap 12 A patient is admitted after brain aneurysm clipping with BP 90/54, HR 110, CVP 1 mm Hg, UO 1,400 mL in four hours, serum Na+ 155, and serum osmolality 320. Which should the nurse anticipate? - ANSWER 0.45% NS bolus and infusion A patient with history of osteoporosis and bone pain is admitted with symptomatic bradycardia and reports recent onset of forgetfulness, loss of appetite, and depression; serum Ca++ 14.5. Administration of which should the nurse anticipate? - ANSWER Isotonic fluids with diuretics to increase renal excretion of calcium in patients with hypercalcemia. Following anesthesia, a patient is disoriented and feels cold despite a blanket, with BP 86/44, temp 35 C, HR 52 sinus bradycardia, RR 10, and TSH 7.4. What initial three interventions should the nurse anticipate? - ANSWER Glucocorticoids, respiratory support, levothyroxine A patient with diabetes who uses an insulin pump is concerned about not managing it during and after surgery. What explanation should the nurse provide about glucose management during and following surgery? - ANSWER We will discontinue your pump and transition to IV regular insulin infusion A patient, without diabetes, is 3 days post-coronary bypass surgery and is on a subcutaneous corrective insulin scale. The blood glucose decreased from 135 mg/dL to 48 mg/dL. 25 mL IV D50 was administered. What response indicates correction of hypoglycemia? - ANSWER Blood glucose is at or above 70 What requirements must be met before transitioning a critically ill patient from continuous regular IV insulin to basal and prandial subcutaneous insulin? - ANSWER Regular insulin is being infused at a low rate. Patient's glucose is stable. Patient's glucose is at a target level. An 85-year-old patient is admitted with dehydration. Fluid resuscitation has been initiated. Serum glucose is 250, and blood ketones are negative. What is this patient's target serum glucose level? - ANSWER 140-180 mg/dL A patient with bronchogenic carcinoma is admitted with lethargy and confusion. Serum sodium is 118. Which intervention should the nurse anticipate? - ANSWER Na+ increase by 0.5 mEq/L/hr with hypertonic saline A patient with a history of Addison's disease is admitted. The patient reports nausea, vomiting, and abdominal pain. Which intervention should the nurse anticipate as the highest priority? - ANSWER Administer dexamethasone A patient with type 2 diabetes who is receiving TPN is started on continuous regular IV insulin. Which treatment priority should the nurse anticipate? - ANSWER Vigilant monitoring of blood glucose What interventions should the nurse be prepared to perform for a patient who is receiving an epinephrine infusion? - ANSWER Regular insulin infusion for blood glucose greater than 180 mg/dL Hourly blood glucose checks Which of the following patients with a history of diabetes is at the highest risk for development of hyperglycemia?