Exam 18: Endocrine Alterations

A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of intravenous (IV)regular insulin to an intensive insulin therapy regimen of insulin glargine (Lantus)and insulin aspart (NovoLog).How should the nurse manage this transition in insulin delivery?

A patient presents to the emergency department ( ED )with the following clinical signs: Pulse: 132 beats/min Blood pressure: 88/50 mm Hg Respiratory rate: 32 breaths/min Temperature: 104.8° F Chest x-ray: Findings consistent with congestive heart failure Cardiac rhythm: Atrial fibrillation with rapid ventricular response These signs are consistent with which disorder?

Mechanisms for development of diabetes insipidus include which of the following? (Select all that apply.)

Which of the following laboratory values would be found in a patient with syndrome of inappropriate secretion of antidiuretic hormone?

An elderly female patient has presented to the emergency department with altered mental status,hypothermia,and clinical signs of heart failure.Myxedema is suspected.Which of the following laboratory findings support this diagnosis?

Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?

A patient with pancreatic cancer has been admitted to the critical care unit with clinical signs consistent with syndrome of inappropriate secretion of antidiuretic hormone.The nurse anticipates that clinical management of this condition will include:

The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte balance is:

A patient is admitted to the oncology unit with a small cell lung carcinoma.During the admission,the patient is noted to have a significant decrease in urine output accompanied by shortness of breath,edema,and mental status changes.The nurse is aware that this clinical presentation is consistent with:

A patient has been on daily,high-dose glucocorticoid therapy for the treatment of rheumatoid arthritis.His prescription runs out before his next appointment with his physician.Because he is asymptomatic,he thinks it is all right to withhold the medication for 3 days.What is likely to happen to this patient?

Factors associated with the development of nephrogenic diabetes insipidus include which of the following? (Select all that apply.)

The nurse is caring for a patient who underwent pituitary surgery 12 hours ago.The nurse will give priority to monitoring the patient carefully for which of the following?

The nurse is providing insulin education for an elderly patient with longstanding diabetes.An order has been written for the patient to take 20 units of insulin glargine (Lantus)at 10 PM nightly.The nurse should instruct the patient that the peak of the insulin action for this agent is:

In the management of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome,when is an intravenous (IV)solution that contains dextrose started?

An individual with type 2 diabetes who takes glipizide (Glucotrol)to control her blood glucose has begun a formal exercise program at a local gym.While exercising on the treadmill,she becomes pale,diaphoretic,and shaky.She has a headache and feels as though she is going to pass out.What is the individual's priority action?

In hyperosmolar hyperglycemic syndrome,the laboratory results are similar to those of diabetic ketoacidosis,with three major exceptions.What differences would you expect to see in patients with hyperosmolar hyperglycemic syndrome?

The nurse is assigned to care for a patient who presented to the emergency department with diabetic ketoacidosis.A continuous insulin intravenous infusion is started,and hourly bedside glucose monitoring is ordered.The targeted blood glucose value after the first hour of therapy is:

The nurse is providing postoperative care to a patient who underwent a transsphenoidal hypophysectomy for a benign pituitary tumor.The nurse administers replacement hydrocortisone,thyroid hormone,and vasopressin.The nurse evaluates that the vasopressin replacement is effective when:

A 20-year-old female with a history of type 1diabetes and an eating disorder is found unconscious.In the emergency department,the following lab values are obtained: Glucose648 mg/dL PH6)88 PaCO₂20 mm Hg PaO₂95 mm Hg HCO_3-undetectable Anion gap>31 Na⁺127 mEq/L K⁺3.5 mEq/L Creatinine1.8 mg/dL After the patient's airway and ventilation have been established,the next priority for this patient is:

What psychosocial factors may potentially contribute to the development of diabetic ketoacidosis? (Select all that apply.)