Complete Solutions
Acute hypercalcemic crisis can occur with extreme elevation of
serum calcium levels. What defines this level of serum calcium?
Correct Answers calcium levels greater than 13mg/dL
(3.25mmol/L) result in neurologic, cardiovascular, and kidney
sx that can be life threatening;
Advanced hypothyroidism. Correct Answers at first, the patient
may be irritable and complain of fatigue, but as the condition
progresses, the emotional responses are subdued. the mental
processes become dulled, and the patient appears apathetic.
speech is slow, the tongue enlarges, the hands and feet increase
in size, and deafness may occur; the patient frequently
complains of constipation. Advanced hypo. may produce
personality and cognitive changes similar characteristic of
dementia;
After surgical removal of the pituitary gland, what can happen in
regards to sexual function? Correct Answers Menstruation
ceases adn infertility occurs after total or near-total ablation of
the pituitary gland.
pg. 1469
After thyroidectomy, what medication/s are given? Correct
Answers thyroid hormone is administered in suppressive doses
to lower the levels of TSH to a euthyroid state; if the remaining
thyroid tissue is inadequate to produce sufficient thyroid
hormone, thyroxine is required permanently;
,Although corticosteroids are highly effective in their treatment,
they may also be very dangerous. What does this entail when
prescribing these medications? Correct Answers dosages are
frequently altered to allow high concentrations when necessary
and then tapered in an attempt to avoid undesirable effects;
this requires patients be monitored closely for side effects and
that the dose should be reduced when high doses are no longer
required;
suppression of the adrenal cortex may persist up to 1 year after a
course of corticosteroids;
Antithyroid agents block the utilization of iodine by interfering
with the iodination of tyrosine and the coupling of iodotyrosines
in the synthesis of thyroid hormones. What are the most
commonly used antithyroid drugs in U.S.? Correct Answers
methimazole (MMI, Tapazole) or propylthiouracil (PTU);
these block extrathyroidal conversion of T4 to T3.
Basophilic tumors cause what type of syndrome? Correct
Answers Cushing syndrome
pg. 1469
Bronchogenic carcinoma is the most common type of cancer
producing Cushing syndrome. Regardless of the cause, what
happens to the feedback system that control function of the
adrenal cortex? Correct Answers they become ineffective, and
the usual diurnal pattern of cortisol is lost;
,Can DI be controlled by limiting fluid intake? Correct Answers
NO; b/c high volume loss of urine continues even without fluid
replacement. attempts to restrict fluids cause the patient to
experience an insatiable craving for fluid and to develop
hypernatremia and severe dehydration;
Causes of hypothyroidism. Correct Answers 1-most common--
> Hashimoto's disease, in which the immune system attacks the
thyroid gland; autoimmune thyroiditis, firm thyroid gland upon
palpation;
2-thyroidectomy, radioiodine treatment, or antithyroid
medications; most frequent in older women;
after treatment with radiation for head/neck cancer in men have
increased risk;
Changes in appearance such as Moon face, Weight gain, and
Acne can develop with corticosteroid therapy. What nursing
interventions should the nurse implement associated with these
side effects? Correct Answers Encourage low-calorie, low-
sodium diet;
assure pt that most changes in appearance are temporary and
will disappear if and when corticosteroid therapy is no longer
necessary;
Characteristics of myxedema coma. Correct Answers initially
will show s&s of depression, diminished cognitive status,
lethargy, and somnolence;
increasing lethargy may progress to stupor; the pt's respiratory
drive is depressed, resulting in alveolar hypoventilation, carbon
dioxide retention, narcosis, and coma;
, hyponatremia, hypoglycemia, hypoventilation, hypotension,
bradycardia, and hypothermia;
Chromophobic tumors represent 90% of pituitary tumors. What
does this type of tumor cause? Correct Answers these tumors
produce no hormones, but destroy the rest of the pituitary gland,
causing hypopituitarism.
pg. 1469
Clinical manifestations of hyperthyroidism. Correct Answers
presenting symptoms is often nervousness;
emotionally hyper-excitable, irritable, apprehensive; cannot sit
quietly; palpitations; pulse is rapid at rest and exertion; tolerate
heat poorly, perspire frequently, skin is flushed with salmon
color in caucasians; skin is warm, soft, and moist; fine tremor of
hands; exophthalmos (abnormal protrusion of one or both
eyeballs) which produces a startled face expression; increased
appetite, dietary intake, weight loss, fatiguability and weakness,
amenorrhea, changes in bowel function; A-fib; sinus tach;
dysrhythmias; increased pulse pressure, palpitations; myocardial
hypertrophy and heart failure;
Clinical Manifestations of Hypothyroidism. Correct Answers
decreased levels of thyroid hormone, extreme fatigue, hair loss,
brittle nails, and dry skin are common; numbness and tingling of
the fingers may occur; voice may become husky; menstrual
disturbances (menorrhagia or amenorrhea), loss of libido; affects
women more than men, most often between 40 and 70 yo;