Endocrine System Disorders | NCLEX Quiz 95

The client should take glipizide twice a day. 30 minutes before a meal. because food decreases its absorption. The drug doesn’t cause hyponatremia and therefore doesn’t necessitate monthly serum sodium measurement. The client must continue to monitor the blood glucose level during glipizide therapy.

The client who has undergone a thyroidectomy is at risk for developing hypocalcemia from inadvertent removal or damage to the parathyroid gland. The client with hypocalcemia will exhibit a positive Chvostek’s sign (facial muscle contraction when the facial nerve in front of the ear is tapped) and a positive Trousseau’s sign (carpal spasm when a blood pressure cuff is inflated for a few minutes). These signs aren’t present with hypercalcemia. hypokalemia. or hyperkalemia.

In the client with hyperthyroidism. excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance. increased protein synthesis and breakdown. decreased glucose tolerance. and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency. making Imbalanced nutrition: Less than body requirements the most important nursing diagnosis. Options B and C may be appropriate for a client with hypothyroidism. which slows the metabolic rate.

This client is having a hypoglycemic episode. Because the client is conscious. the nurse should first administer a fast-acting carbohydrate. such as orange juice. hard candy. or honey. If the client has lost consciousness. the nurse should administer either I.M. or subcutaneous glucagon or an I.V. bolus of dextrose 50%. The nurse shouldn’t administer insulin to a client who’s hypoglycemic; this action will further compromise the client’s condition.

Serum osmolarity is the most important test for confirming HHNS; it’s also used to guide treatment strategies and determine evaluation criteria. A client with HHNS typically has a serum osmolarity of more than 350 mOsm/L. Serum potassium. serum sodium. and ABG values are also measured. but they aren’t as important as serum osmolarity for confirming a diagnosis of HHNS. A client with HHNS typically has hypernatremia and osmotic diuresis. ABG values reveal acidosis. and the potassium level is variable.

Exercise. reduced food intake. hypothyroidism. and certain medications decrease the insulin requirements. Growth. pregnancy. greater food intake. stress. surgery. infection. illness. increased insulin antibodies. and certain medications increase the insulin requirements.

The client should be instructed always to follow the same order when drawing the different insulins into the syringe. Insulin should never be shaken because the resulting froth prevents withdrawal of an accurate dose and may damage the insulin protein molecules. Insulin also should never be frozen because the insulin protein molecules may be damaged. Intermediate-acting insulin is normally cloudy.

For this client. wet-to-dry dressings are most appropriate because they clean the foot ulcer by debriding exudate and necrotic tissue. thus promoting healing by secondary intention. Moist. transparent dressings contain exudate and provide a moist wound environment. Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Dry sterile dressings protect the wound from mechanical trauma and promote healing.

The client should be encouraged to force fluids to prevent renal calculi formation. Sodium should be encouraged to replace losses in urine. Restricting potassium isn’t necessary in hyperparathyroidism.

As a normal body protein. glucagon only interacts adversely with oral anticoagulants. increasing the anticoagulant effects. It doesn’t interact adversely with anabolic steroids. beta-adrenergic blockers. or thiazide diuretics.