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The Nurse Recognizes Which Symptoms Are Characteristic Of Impending Diabetic Ketoacidosis

N-clex Flashcards

N-clex Flashcards

A 25-year-old female is concerned about the possibility of contracting measles after a recent case at the day care center where she is employed. Her immunizations are up to date. The nurse recommends: Seeking a prescription for prophylactic antibiotics. Immediate administration of an MMR immunization. The nurse administers DPT, polio, Hib and hepatitis B immunizations to a 2-month-old child. Which of the following would be appropriate instructions for this child's mother? Remain in the clinic 30 minutes after receiving the immunizations for observation. Administer baby aspirin for fever and discomfort. Return to the clinic for the next immunizations at 6 months of age. Call the physician if redness develops at the site of the injections Remain in the clinic 30 minutes after receiving the immunizations for observation Which of the following patient statements would indicate the need for more teaching to a patient taking immunosuppressant therapy? "I will need regular laboratory testing." "I can visit my neighbor in the hospital every day." "I should not visit my neighbor in the hospital every day. "I banked egg/sperm prior to beginning this treatment. "I can visit my neighbor in the hospital every day." A patient is taking sirolimus (Rapamune) following a liver transplant. On the most recent CBC, the nurse notes a marked 50% decrease in platelets and leukocytes. During the physical assessment, what signs and symptoms should the nurse look for? What are appropriate nursing interventions? Sirolimus (Rapamune) is an immunosuppressant. The nurse should assess for any signs and symptoms of bleeding or jaundice and infection. The nurse should question the patient regarding activities that may cause bleeding. The nurse should also assess for signs and symptoms of liver impairm Continue reading >>

Catalog Detail

Catalog Detail

NAU Med Surg Cardiac, FE, DM, Renal, Resp You are caring for a patient with metastatic bone cancer. Which of the followingclinical manifestations would alert you to the possibility of hypercalcemia inthis patient?A)Muscle tremorsB)Facial spasmsC) WeaknessD)Paresthesia C. Weakness. Feedback: Signs of hypercalcemia arelethargy, headache, weakness, muscle flaccidity, heart block, anorexia, nausea,and vomiting. Paresthesia, facial spasms, and muscle tremors are symptoms ofhypocalcemia. Patient with renal failure who has been taking aluminum hydroxide/magnesiumhydroxide suspension (Maalox) at home for indigestion is somnolent and hasdecreased deep tendon reflexes. Which action should the nurse take first?A)Notify the patients health care provider.B)Withhold the next scheduled dose of Maalox.C) Check the chart for the most recent potassium level.D) Review the magnesium level on the patients chart. D. Review the magnesium level on the patients chart. Feedback: The patient has a history andsymptoms consistent with hypermagnesemia; the nurse should check the chart fora recent serum magnesium level. Notification of the health care provider willbe done after the nurse knows the magnesium level. The Maalox should be held,but more immediate action is needed to correct the patient's decreased deeptendon reflexes (DTRs) and somnolence. Monitoring of potassium levels also isimportant for patients with renal failure, but the patient's current symptomsare not consistent with hyperkalemia. The nurse notes that a patient who was admitted with diabetic ketoacidosis hasrapid, deep respirations. Which action should the nurse take?A) Notify the patients health care provider.B) Give the prescribed PRN lorazepam (Ativan).C) Start the prescribed PRN oxygen at 2 to 4 L/min.D) Encourage the patien Continue reading >>

Endocrine And Metabolic Emergencies In Children: Hypocalcemia, Hypoglycemia, Adrenal Insufficiency, And Metabolic Acidosis Including Diabetic Ketoacidosis

Endocrine And Metabolic Emergencies In Children: Hypocalcemia, Hypoglycemia, Adrenal Insufficiency, And Metabolic Acidosis Including Diabetic Ketoacidosis

Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis It is important to fast diagnosis and management of the pediatric patients of the endocrine metabolic emergencies because the signs and symptoms of these disorders are nonspecific. Delayed diagnosis and treatment may lead to serious consequences of the pediatric patients, for example, cerebral dysfunction leading to coma or death of the patients with hypoglycemia, hypocalcemia, adrenal insufficiency, or diabetic ketoacidosis. The index of suspicion of the endocrine metabolic emergencies should be preceded prior to the starting nonspecific treatment. Importantly, proper diagnosis depends on the collection of blood and urine specimen before nonspecific therapy (intravenous hydration, electrolytes, glucose or calcium injection). At the same time, the taking of precise history and searching for pathognomonic physical findings should be performed. This review was described for fast diagnosis and proper management of hypoglycemic emergencies, hypocalcemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis. Keywords: Hypoglycemia, Hypocalcemia, Adrenal insu Continue reading >>

Kaplan Endocrine System

Kaplan Endocrine System

The nurse understands that which statement BEST describes the action of glucocorticoids? a) Prepare for "fight or flight" mechanism glucocorticoids are secreted by the adrenal cortex; primary glucocorticoid is cortisol; cortisol, or steroids, provide rapid energy from the conversion of proteins and fats into glucose; are also potent anti-inflammatory agents it is important for the nurse to monitor a client with Addison's disease for the development of which condition? have little energy and are prone to fatigue; other symptoms include bradycardia, intolerance to the cold, dull and dry hair, alopecia, and obesity The nurse instructs a client about insulin self-administration. It is MOST important for the nurse to make which statement? a) "You should rotate the injection sites." b) "Wipe the needle with alcohol prior to the injection." c) "Hold the hub of the needle when drawing up the medication." d) "Cool the insulin prior to injecting it." a) "You should rotate the injection sites." the site of injection must be rotated in order to get proper absorption; lipodystrophy can occur with repeated injections, and can cause poor absorption of the insulin The nurse in the outpatient clinic cares for a client with the diagnosis of Cushing's disease. The nurse should expect to observe which symptom? even though there is truncal obesity, clients will have thin arms and legs due to muscle wasting; will also have edema, purple skin striations, and a decreased resistance to infection Following a client's treatment for Addison's disease, the nurse plans for the client's discharge. The client asks the nurse how long the medication must be continued. The nurse's response should include which information? c) "Until the lab values are within normal limits." glucocorticoids, hormones tha Continue reading >>

Evolve: Endo Essay | Medicine And Health Articles

Evolve: Endo Essay | Medicine And Health Articles

The nurse identifies that the dietary teaching provided for a client with diabetes is understood when the client states, My diet: Can be planned around a wide variety of commonly used foods. A nurse is caring for a client who was admitted to the hospital with a diagnosis of Addison disease. The nurse should assess the client for what signs related to this disorder? The nurse is caring for a client diagnosed with Cushing syndrome. The nurse expects that the client will exhibit: A client is scheduled to have a thyroidectomy for cancer of the thyroid. Preoperative instructions for the postoperative period include teaching the client to: Support the head with the hands when changing position Which health problem should the nurse consider is most likely to precipitate acute hypoglycemia in a client? Clients with liver disease have a decreased ability to metabolize carbohydrates because of a decreased ability to form glycogen and to form glucose from glycogen. Cushings syndrome causes hyperglycemia. The nurse is counseling a client with type 1 diabetes about the clients favorite foods that are lowest in carbohydrates (CHO). The nurse determines that this concept is understood when the client chooses eight ounces of: Skim milk contains about 12 grams of CHO per cup. There are about 30 grams CHO in 1 cup of apple juice. There are about 16 grams CHO in 1 cup of nonfat yogurt. There are about 25 grams CHO in 1 cup of orange juice A client is admitted to the hospital for a subtotal thyroidectomy. When discussing postoperative drug therapy with the client, the nurse should teach the client to: Report palpitations, nervousness, tremors, or loss of weight that may indicate an overdose of thyroid hormone A client is diagnosed as having type 2 diabetes. A priority teaching goal is, Th Continue reading >>

Endocrine/metabolic At University Of California - Irvine - Studyblue

Endocrine/metabolic At University Of California - Irvine - Studyblue

The nurse performs a home care visit for a child diagnosed with cystic fibrosis. The nurse should intervene if which of the following is observed? a) the child eats a high-protein, high-calorie diet b) the child has two to three stools per day c) the child swallows the pancreatic enzyme capsules whole d) the child takes the pancreatic enzymes one hour after eating d) the child takes the pancreatic enzymes one hour after eating The nurse on the medical unit expects which medication to be administered to a newly diagnosed patient with type 2 diabetes mellitus who is experiencing hyperglycemia? In preparation for patient discharge, a nurse reviews that diabetic exchange list with a patient diagnosed with type 1 diabetes. The nurse informs the patient that sandwich made with two slices wheat bread, one slice of turkey, 1 tsp of mayonnaise, and two lettuce leaves is the equivalent of what? a) 1 bread exchange, 2 meat exchange, 1/2 fat exchange, and 1 fruit exchange 2) 2 bread exchanges, 1 meat exchange, 1 fat exchange, and 1 vegetable exchange c) 1 bread exchange, 2 meat exchanges, 2 fat exchanges d) 2 bread exchanges, 1 meat exchange, 1 fat exchange, and 2 vegetable exchanges 2) 2 bread exchanges, 1 meat exchange, 1 fat exchange, and 1 vegetable exchange The nurse knows that serum albumin is used as an indicator of malnutrition because a) albumin from eggs is commonly ingested, and can be assumed to be constant in the American diet b) albumin is the first result on a protein electrophoresis, and often found on the hospital chart c) serum albumin is easy to measure, and can indicate a protein deficiency that may not be detected on physical examination d) serum albumin has a short half-life, so it is an easy protein to measure c) serum albumin is easy to measure, and can ind Continue reading >>

Kaplan Endocrine System A

Kaplan Endocrine System A

In teaching a client with Addison's disease about dietary needs, the nurse should emphasize the important of consuming which nutrient? Sodium -> hypofunction of the adrenal glands causes hyponatremia and hypoatremia include nausea, muscle cramps, increased intracranial pressure, confusion, muscular twitching, and convulsion; adjust intake of sodium the nurse cares for a client after a subtotal thyroidectomy. the nurse identifies that damage to the parathyroid gland is indicated by which symptom? numbness in the fingers -> damage to the parathyroids may cause a decrease in calcium, which would be manifested by numbness; also causes tetany, seizures, confusion, Trousseau's sign and Chvosetk's sign the nurse assesses a client receiving levothyroxine sodium. which indicates a favorable outcome to the nurse? increased urine output. -> synthroid increase metabolic processes in the body, including glomerular filtration, thereby increasing urine output; edema will decrease as the water is excreted via the kidneys; side effects include nervousness, tremors, insomnia, tachycardia, and palpitations; nurse should instruct client to report chest pain, palpitations, sweating, nervousness, and shortness of breath to health care provider; take medication at the same time every day in the AM the nurse in the outpatient clinic cares for a client with the diagnosis of Cushing's disease. the nurse should expect to observe which symptom? thin legs and arms. -> even though there is truncal obesity, clients will have thin arms and legs due to muscle wasting; will also have edema, purple skin striations, and a decreased resistance to infection the nurse monitors the client diagnosed with type 1 diabetes. the client tells the nurse, "I jog 30 minutes every day but today after my jog I felt ner Continue reading >>

Nursing Care: Sample Questions Ii

Nursing Care: Sample Questions Ii

Medical Surgical Nursing Practice Test Part 1 1. Mrs. Chua a 78 year old client is admitted with the diagnosis of mild chronic heart failure. The nurse expects to hear when listening to clients lungs indicative of chronic heart failure would be: 2. Patrick who is hospitalized following a myocardial infarction asks the nurse why he is taking morphine. The nurse explains that morphine: d. Helps prevent fibrillation of the heart 3. Which of the following should the nurse teach the client about the signs of digitalis toxicity? d. Visual disturbances such as seeing yellow spots 4. Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for this is to help b. Excrete excessive fluids accumulated at night c. Prevents sleep disturbances during night 5. What would be the primary goal of therapy for a client with pulmonary edema and heart failure? 6. Nurse Linda is caring for a client with head injury and monitoring the client with decerebrate posturing. Which of the following is a characteristic of this type of posturing? a. Upper extremity flexion with lower extremity flexion b. Upper extremity flexion with lower extremity extension c. Extension of the extremities after a stimulus d. Flexion of the extremities after stimulus 7. A female client is taking Cascara Sagrada. Nurse Betty informs the client that the following maybe experienced as side effects of this medication: 8. Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from myocardial infarction. Which of the following is the most essential nursing action? b. Monitoring blood pressure every 4 hours c. Obtaining serum potassium levels daily d. Obtaining infusion pump for the medication 9. During the second day of hospitalization of the cl Continue reading >>

Endocrine Flashcards Preview

Endocrine Flashcards Preview

d. An increase in height of 2 to 3 inches a year The increased production of GH in acromegaly causes an increase in thickness and width of bones and enlargement of soft tissues, resulting in marked changes in facial features, oily and coarse skin, and speech difficulties. A patient with acromegaly is treated with a transsphenoidal hypophysectomy. What should the nurse do postoperatively? a. Ensure that any clear nasal drainage is tested for glucose b. Maintain the patient flat in bed to prevent cerebrospinal fluid (CSF) leakage. c. Assist the patient with toothbrushing every 4 hours to keep the surgical area clean d. Encourage deep breathing, coughing, and turning to prevent respiratory complications a. Ensure that any clear nasal drainage is tested for glucose A transsphenoidal hypophysectomy involves entry into the sella turcica through an incision in the upper lip ans gingiva into the floor of the nose and the sphenoid sinuses. Postoperative clear nasal drainage with glucose content indicates CSF leakage from an open connection to the brain, putting the patient at risk for meningitis. After surgery, the patient is positioned with the head elevated to avoid pressure on the sella turcica. Coughing and straining are avoided to prevent increased ICP and CSF leakage. Although mouth care is required every 4 hours, toothbrushing should not be performed because injury to the suture line may occur. c. Excess follicle-stimulating hormone (FSH) and luteinizing hormone (LH) d. Signs of increased intracranial pressure, including headache, nausea, and vomiting d. Signs of increased intracranial pressure, including headache, nausea, and vomiting Compression of the optic chiasm can cause visual problems as well as signs of increased ICP, including headache, nausea, and vomiting. Ab Continue reading >>

Kaplan Endocrine System

Kaplan Endocrine System

1. damage to the parathyroid gland causes hypocalcemia; hypercalcemia causes muscle weakness and lack of coordination 2. CORRECT - damage to the parathyroids may cause a decrease in calcium, which would be manifested by numbness; also causes tetany, seizures, confusion, Trousseau's sign and Chvostek's sign The nurse knows that a blood sugar level of 40mg/dL indicates which condition? 1. diabetic ketoacidosis is caused by inadequate amounts of insulin; causes hyperglycemia, dehydration, electrolyte loss, and acidosis 3. CORRECT - a blood sugar level of 40 mg/dL is indicative of hypoglycemia; most likely due to decreased food intake or too much insulin 4. abnormal amount of glucose in the urine; occurs when blood glucose exceeds renal threshold (above 170 mg/dL) On the day of discharge, the client newly diagnosed with type 1 diabetes says to the nurse. "Tell me again, what should I do if I develop a fever?" Which response by the nurse is BEST? 1. "Increase your caloric intake and decrease your insulin dosage." 2. "Discontinue taking insulin until after your febrile state has passed." 3. "Continue taking insulin as prescribed." 4. "Contact your physician to have the insulin dosage adjusted." 1. need for insulin will increase during illness; should test blood glucose every 3-4 hours; if usual meal plan can't be followed, substitute soft foods 3. CORRECT - need for insulin is increased with any concurrent illness, especially an infection; presence of a fever, inability to ingest food, and erratic blood glucose levels are all reasons for an immediate call to the physician 4. contact physician if having nausea, vomiting, and diarrhea The home care nurse monitors a client 7 days after a transphenoidal hypophysectomy. The nurse should intervene if which is observed. 1. The clie Continue reading >>

Airway Obstruction And Asthma

Airway Obstruction And Asthma

An elderly client with pneumonia may appear with which of the following symptoms first? 2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop? 3. A 7-year-old client is brought to the E.R. Hes tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may have which of the following? Chronic obstructive pulmonary disease (COPD) 4. Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder? 5. Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection? 6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away? 7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first? 8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions? Adult respiratory distress syndrome (ARDS) 9. The term blue bloater refers to which of the following conditions? Adult respiratory distress syndrome (ARDS) 10. The term pink puffer refers to the client with which of the following conditions? 11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. Hes tachypneic, with a prolonged expiratory p Continue reading >>

Practice Makes Perfect: 20 Nclex Practice Questions Ati Nursing Blog

Practice Makes Perfect: 20 Nclex Practice Questions Ati Nursing Blog

They say practice makes perfect and when it comes to passing the NCLEX that is certainly the case. ATI Nursing Education wants to share 20 NCLEX practice questions to help you perfect your test-taking skills and knowledge. PS: Dont forget to scroll to the end of the article for answers and rationales. Question 1: A nurse cares for a toddler who has a decreased appetite, an erratic eating pattern, and fussiness at mealtime. Which recommendation should be made to the parents? Reward the child with a favorite dessert. Offer fruit juice in a cup throughout the day. Provide nutritious snacks at regular intervals. Question 2: A nurse provides care for a client who is 1-day post-partum following a vaginal delivery. Which task can be delegated to the assistive personnel (AP)? Question 3: A nurse plans teaching for a client who has coronary artery disease. Which dietary recommendation is most important? Prepare foods by broiling instead of frying. Drink almond milk in place of soft drinks. Eat tortillas made from corn rather than flour. Question 4: A client who has endometrial cancer is receiving sealed internal radiation therapy. Which actions should the nurse implement? Select all that apply. Instruct visitors to wear a dosimeter badge. Place dislodged source in biohazard container. Do not allow women who are pregnant to visit. Question 5: A nurse cares for a group of clients who are experiencing symptoms of withdrawal from alcohol. Which finding requires immediate follow-up? Question 6: A nurse provides discharge teaching for a client who had a below-knee amputation. Which instructions should the nurse include? Select all that apply. Question 7: A toddler is dehydrated as the result of complications from varicella-zoster virus. Fluid filled vesicles are observed on the face Continue reading >>

Print Nursing 3 Exam 1 Study Guide Brunner 51, Brunner 31 Flashcards | Easy Notecards

Print Nursing 3 Exam 1 Study Guide Brunner 51, Brunner 31 Flashcards | Easy Notecards

Chapter 51: Assessment and Management of Patients With Diabetes - Page 1428 NPH is an example of which type of insulin? Presence of autoantibodies against islet cells Explanation: There is evidence of an autoimmune response in type 1 diabetes. This is an abnormal response in which antibodies are directed against normal tissues of the body, responding to these tissues as if they were foreign. Autoantibodies against islet cells and against endogenous (internal) insulin have been detected in people at the time of diagnosis and even several years before the development of clinical signs of type 1 diabetes. Chapter 51: Assessment and Management of Patients With Diabetes - Page 1418 A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which of the following factors as a cause of type 1 diabetes? Explanation: The nurse should observe the patient receiving an oral antidiabetic agent for the signs of hypoglycemia. The time when the reaction might occur is not predictable and could be from 30 to 60 minutes to several hours after the drug is ingested. Polyuria, polydipsia, and blurred vision are the symptoms of diabetes mellitus. Chapter 51: Assessment and Management of Patients With Diabetes - Page 1433 A patient with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which of the following symptoms when caring for this patient? Explanation: ) Neuropathy results from poor glucose control and decreased circulation to nerve tissues. Neuropathy involving sensory nerves located in the periphery can lead to lack of sensitivity, which increases the potential for soft tissue injury without client awareness. The feet are inspected on each visit to in Continue reading >>

Test: Bstrandable Nclex Miscellaneous 2 | Quizlet

Test: Bstrandable Nclex Miscellaneous 2 | Quizlet

With glomerulonephritis you should consider Which of the following physical assessment findings are normal for a client with advanced chronic obstructive pulmonary disease (COPD)? 1. Increased anteroposterior chest diameter. 4. Increased chest excursions with respiration. when we get a nurse from another unit to our floor, what do we consider them Describe the method of drawing up a mixed dose of insulin, regular with NPH 632. The nurse is reviewing the laboratory results in a client with cirrhosis and notes that the ammonia level is elevated. Which diet does the nurse anticipate to be prescribed for this client? A nurse is performing wound care. Which of the following practices violates surgical asepsis? a. Holding sterile objects above the waist b. Considering a 1 edge around the sterile field as being contaminated c. Pouring solution onto a sterile field cloth d. Opening the outermost flap of a sterile package away from the body 31. The emergency department nurse will suspect a tension pneumothorax in a patient who has been in an automobile accident if a. the breath sounds on one side are decreased. b. there are wheezes audible throughout both lungs. c. there is a sucking sound with each patient breath. d. paradoxic movement of the chest is noted. An 85 yo pt is assessed to have a score of 16 on the Braden scale. Based on this information, how should the nurse plan for this pts care? 2. One method of developing a theory is by first examining a general idea and then considering specific actions or ideas. What is the method called? How does the nurse prevent hypoxia during suctioning? Triiodothyronine (T-3) Lab Values: Newborn "While completing the preoperative assessment, the male client tells the nurse that heis allergic to codeine. Which intervention should the nur Continue reading >>

Kaplan Endocrine System A

Kaplan Endocrine System A

The nurse recognizes which symptoms are characteristic of impending diabetic ketoacidosis? Hot, dry, flushed skin, excessive thirst, rapid pulse. The nurse monitors the client diagnosed with type 1 diabetes. The client tells the nurse, "I jog 30 minutes every day but today after my jog I felt nervous, hungry, and had tremors." Which statement by the nurse is best? You should eat cheese and crackers prior to jogging. The nurse cares for a client diagnosed with a syndrome of inappropriate antidiuretic hormone (SIADH). The nurse is most concerned if which is observed? The nurse cares for a client immediately after a thyroidectomy. It is most important for the nurse to contact the health care provider if which is observed? It is important for the nurse to monitor a client with Addison's disease for the development of which condition? The nurse identifies the treatment of choice for severe ketoacidosis in a conscious person in which? The nurse cares for a client with diagnosed with diabetes insipidus. The health care provider prescribes vasopressin. The nurse determines that the medication is effective if which observation is made? A client diagnosed with type 1 diabetes asks the nurse why "a pill" for diabetes can't be taken. Which best describes the action of oral hypoglycemic agents? They stimulate beta cells in the pancreas to release endogenous insulin. The nurse understands that which statement best describes the action of glucocorticoids? the nurse knows that a blood sugar level of 40 mg/dL indicates which condition? On the day of discharge, the client newly diagnosed with type 1 diabetes says to the nurse, "Tell me again, what should I do if I develop a fever?" Which response by the nurse is best? A client is evaluated in the outpatient clinic for hypothyroidism. Th Continue reading >>

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