NUR 100 – EXAM 3 Endocrine/Diabetes/ Neuro
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NUR 100 – EXAM 3 Endocrine/Diabetes/ Neuro
Question 1
The primary reason for conducting osmotic diuretics is to decrease intracranial pressure and intraocular pressures. They represent a class of drugs that enhance the generation of urine in individuals with osmotic pressure in the kidney. The drug also promote the release of nephrotoxic elements such as cisplatin. The class of drugs differ from other diuretics which are prescribed to hypertension patients.
Question 2
The most suitable intervention for the nurse in this instance is to place a bite stick or tongue blade between the patient’s teeth. The action would prevent the risk of aspiration, which is the accidental breathing in of fluids or food into the lungs. Such an incident could be fatal and may cause further damage to the lungs.
Question 3
The most suitable intervention for the patient demonstrating positive Trousseau’s sign is to administer calcium carbonate by mouth. Calcium supplements, usually offered by mouth, are all that is required to mitigate hypocalcemia. If a cause is recognized early enough, handling the problem resulting in hypocalcemia or altering drugs may reinstate the calcium levels.
Question 4
The statement, which shows the need for more diabetic teaching is the one where a patient feels they can relax his dietary restrictions now that he is on insulin.” Whereas a person on insulin may have more flexibility about what they consume, it is imperative to be watchful of what one consumes to avoid worsening the case.
Question 5
A lumbar puncture performed by inserting a needle into the space within the spinal column help to diagnose or treat a particular condition. The most suitable action for a patient scheduled for a lumbar puncture is to administer a sedative medication thirty minutes prior to the procedure. The most suitable anesthesia in this instance is local anesthesia that help to subdue possible pain.
Question 6
Diabetic clients undergoing surgery requires special monitoring during surgery because stress of surgery can result in hyperglycemia. General sedation or anesthesia can disguise a hypoglycemia-changed mental status. Severe hypoglycemia may cause permanent harm to the brain. Special attention is needed during surgery because there is no wat to discover hypoglycemia when administering general anesthesia other than monitoring blood glucose intermittently.
Question 7
The best intervention based on the intervention would be to administer half cup of grape juice to the diabetic patient who feels weak and shaky who also appears to be anxious and nervous. The shaky feeling may be a sign of hypoglycemia, which is attributed to decreased blood sugar. Hence, offering the juice would help stabilize blood sugar levels.
Question 8
Disruption in ability to read, write, speak, and comprehend speech following a stroke is called aphasia. The condition generally deprives one the ability to communicate. The condition usually emerges following a head injury or a stroke as it happens in this case.
Question 9
An elderly diabetic patient may display symptoms such as warm dry skin, altered mental status, and polyuria, which is increased urination. However, an elderly diabetic patient would not demonstrate hypothermia, which emerge as a result of being exposed to cold temperatures for prolonged hours.
Question 10
Hypocalcaemiais a process associated with numbness and tingling of fingers and toes. Hence, the most suitable action in instance where a patient develops the symptoms following a subtotal thyroidectomy is to examine the most recent serum calcium level. The action is necessary because patients undergoing a thyroidectomy may experience a drop in calcium level below normal rates.
Question 11
The two highest preference nursing diagnoses to apply to a client having seizure are to take into account ineffective airway clearance and risk for injury and to assess risk for injury and self-esteem disturbance. Assessing risk for injury is important because it is encounter self-harm when encountering seizure. Moreover, it is essential to ensure that the patient keeps breathing regardless of the condition.
Question 12
General cognitive harm and memory loss are both indications of type 2 diabetes. Hence, it is imperative to assess for diabetes mellitus for a client with complaints of memory loss. Some researcher content that some diabetic people may experience insulin resistance in the brain. The resistance to insulin could affect brain cells and may result in memory loss.
Question 13
A client with fasting blood glucose level between 70 and 80 mg/dL, blood glucose level below 200 mg/dL, and hemoglobin A1c level of 5.5% could show a wide range of symptoms. Some of the potential indications may include enhanced risk for developing ketoacidosis, enhanced risk for developing hypoglycemia, and may also be an indication for insulin resistance.
Question 14
It is normal for a patient to experience dizziness and confusion following craniotomy surgery. A person may also become increasingly restless. Therefore, the most suitable intervention in this case is to monitor the patient for some time before taking any intervention. The intervening practitioner can then inform other interveners when it is apparent the symptoms are not lessening.
Question 15
Total thyroidectomy entails removing the whole thyroid gland. The procedure is often conducted to mitigate thyroid cancer, but may also be performed to address goiter or hyperthyroidism. A person recovering from the operation may experience chronic pain because of the extracted gland. However, the main will continue to go down with proper intervention.
Question 16
The type of stroke that is associated with atrial dysrhythmias and valvular heart disease is hemorrhagic stroke. Atrial dysrhythmias affects blood flow and increases heart rate. On the other hand, valvular heart disease happens when one or more valves leading blood to the heart may not function adequately.
Question 17
The primary reason for offering Tapazole and iodine prior to surgery is to minimize synthesis of thyroid hormone and minimize the size and vascularity of the thyroid gland. Consequently, it is imperative for interveners to pay considerable attention when intervening for a patient with Graves’ disease.
Question 18
Hypothyroidism is a condition where the thyroid lacks the capacity to form and excrete adequate thyroid hormone into the bloodstream. The condition slows metabolism processes significantly. Hence, a person living with the condition should take a diet that is enriched fiber and has low calorie. Consuming food rich in fiber, for example, minimizes cholesterol levels.
Question 19
A person with leg paralysis and facial drooping on the right side following a stroke is likely to encounter complications in speaking. The primary cause for the problem is dysphasia or aphasia, which emanates due to damage in an area of the brain that regulates language. The part of the brain that is damaged is known as the Wernicke’s area.
Question 20
The most suitable way to decrease insulin needs is to encourage a client with diabetes is to walk 1 mile every day. There are various ways that physical exercise minimizes blood sugar. Insulin sensitivity is enhanced, so the muscles cells are in a good position to utilize any available insulin to consume glucose when exercising and after the exercise.
Question 21
The duration of impact of NPH is about 16 to 20 hours, which is considerably shorter other insulins that have a prolonged effect that extend beyond 24 hours. Hence, it implies that NPH should be administered twice every day to attain sustained control for more than 24 hours.
Question 22
A person taking oral hypoglycemic agents and is prescribed insulin at the health facility should understand that oral hypoglycemic drugs can interact with antibiotics. The interaction is likely to happen because diabetic patients who take particular class of antibiotics are likely to encounter more serious blood sugar alterations than those who use of forms of drugs.
Question 23
The health care provider should inform a patient with cerebral atherosclerosis and is taking clopidogrel (Plavix) should understand that taking the drug may help to minimize the risks of clot formation. The drug minimizes the capacity of the platelets to cling together and minimizes the threat of clots creation. The prevention is because the drug functions as an antiplatelet.
Question 24
A common respiratory symptom associated with ketoacidosis is rapid deep respirations. Respiratory compensation for this condition causes Kussmaul respirations, which is characterized by rapid, shallow breathing that as the condition becomes increasingly severe, becomes less rapid, constrained, and deeper.
Question 25
The most suitable way to communicate with a patient with aphasia ask less complex questions that the patient can respond to with yes or no. Using simple questions saves the patient the stress of having to use many words to respond to the questions yet the condition makes it difficult to communicate.
Question 26
The most suitable action after assessing a patient’s gag reflex after encountering a stroke in an attempt to commence oral feeding is to order a varied pureed diet. The diet does not require one to chew and may include foods such as pudding and potatoes. It may be necessary to blend the foods to make it easier to swallow.
Question 27
The common electrolyte imbalance that may be witnessed following the treatment for ketoacidosis is hypernatremia. Hence, some parts of the body such as nerve cells, the muscle, and the heart may not function normally.
Question 28
The most important risk factor to address when handling a patient who is at risk of encountering stroke is to monitor the BP and find ways for stabilizing it within normal levels. 180/90 mm Hg is far much higher than the recommended 120/80 mmHg or less.However, failing to address the sign could increase risk for stroke.
Question 29
The test that should be performed first to the patient who developed right-sided weakness that commenced 90 minutes earlier is to conduct a chest x-ray that may help to identify whether certain physical factors are the cause of the weakness.
Question 30
A nurse can delegate to an LPN/LVN the task of determining when the stroke symptoms commenced when handling a patient who has been witnessing stroke symptoms for one hour. The information would help to understand whether the symptoms would turn into real stroke.
Question 31
The most suitable procedure is to give oxygen to keep O2 saturation >95, use National Institute of Health Stroke Scale to assess the case, perform CT scan without contrast, and give tissue plasminogen activator (tPA) a thrombolytic drug (3412).
Question 32
Vaccines play fundamental functions in preventing meningococcal disease. Hence, the most suitable intervention in this instance is to give immunization to adolescents and college freshman against Neisseria meningitides.
Question 33
The intervention that requires an RN’s intervention is ensuring that the patient gets the most appropriate diet from the dietary department. Adequate monitoring in this area would help to avert a situation where the condition worsens due to poor diet. However, the nurse can take care of the other requirements.
Question 34
An incident that should be reported immediately to the health care provider when assessing the patient is a positive Kerning’s sign because inability to move the knee or increased pain may warrant urgent attention.
Question 35
The first response in this case would be to obtain oxygen saturation because the process would help to determine the amount of oxygen moving through the body with the red blood cells. The objective is to restore oxygen saturation within normal levels of 95% and 100%.
Question 36
A renal patient on dialysis is more likely to experience hyperparathyroidism, which is associated with increased release of parathyroid hormone (PTH). This is because their kidneys do not function properly.
Question 37
The most suitable intervention in this case is to begin by easing the patient’s temperature with a cooling blanket. The intervention would help to regulate the high temperature.
Question 38
The assessment information that needs the fastest response when dealing with a patient with acute encephalitis is that the client reports of increased headaches ranging 5 of a 10-point scale. The headache could be a sign of swelling or increased viral infection.