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1) Answer the following questions related to abnormal assessment findings of the endocrine system.

a. Heat intolerance is associated with what secretion of the thyroid gland?

b. Striae are associated with excessive secretion of what gland?

c. Moon face is associated with the secretion of what of the adrenal gland?

d. Exophthalmos is associated with excessive secretion of what gland?

e. Hyperpigmentation is associated with hypofunction of what gland?

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2) Determine whether each description is characteristic of type 1 or type 2 diabetes.

  •  Insulin resistance
  • Beta cell secretory exhaustion
  • Inherited defect in insulin receptors
  • Production of islet-cell antibodies
  • Genetic susceptibility for antibody production

3) What five signs and symptoms are found in patients diagnosed with DKA that are not found in HHS?

4) What is a thyroid storm and provide four clinical manifestations?

5) Name four effects aging have on the endocrine system.

 

6)  What are two primary laboratory findings used to confirm the diagnosis of hyperthyroidism and what test is used to differentiate Graves’ disease from other thyroid problems?

7)  Describe the difference between hyperparathyroidism and hypoparathyroidism. Provide a nursing intervention for each.

8) Describe the difference between hyperthyroidism and hypothyroidism. Provide a nursing intervention for each.

A 48-year-old female patient is scheduled for an incisional biopsy to evaluate a lump in her left breast. You are the nurse in the ambulatory care center where the procedure will take place.

Critical Thinking Questions: Answer each question completely and thoroughly.

1) How ill you describe the surgery to the patient when she arrives at the clinic?

2) If the biopsy is malignant, list three nursing diagnoses for this patient.

3) How could breast cancer treatment affect sex and intimacy for the patient?

4) What steps would you take when helping the patient decide what treatment to undergo for breast cancer?

5) How would you describe a modified radical mastectomy to the patient?

C. S., a 60-year-old truck driver, has been diabetic and has required insulin therapy for the past 12 years. Diabetic neuropathy has led to several complications, including end-stage renal disease, which he developed two years ago. He now receives hemodialysis three times a week and has an AV fistula in his left forearm. Yesterday, C. S. presented in the ED with a respiratory infection and was hospitalized with pneumonia, hypertension, and fluid overload. He will receive dialysis while on your nursing unit.

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Critical Thinking Questions: Answer each question completely and thoroughly.

1) Is it appropriate to administer an aminoglycoside antibiotic for his respiratory infection? Why or why not?

2) What changes would you expect to see in this patient’s blood glucose levels during and after hemodialysis? What nursing care would you provide during and after hemodialysis?

3) C. S. missed his dialysis treatment on the day of admission. How might this be evidenced in his respiratory status? What care would you expect to provide next and why?

4) His wife comments on the fruity odor of his breath. What complication would cause this sign? What should you do next and why?

5) C.S. complains of dry, itching skin. How would you explain this symptom to him? What nursing measures for skin care would you provide and why?

 

Answer each question thoroughly and completely.

Patient Profile: C.W., a 35-year-old female patient, has just been diagnosed with systemic lupus erythematosus and is concerned about the impact of this multisystem disease process. You are the nurse that has been assigned to take care of this patient.

Critical Thinking Questions

1) What background information can you obtain from C.W. that would help you determine how the patient is reacting to the diagnosis?

2) When C.W. asks you what “multisystem disease process” means, how would you respond?

3) What diagnostic tests would serve to establish C.W.’s immune baseline?

4) What measures could you include with regard to discharge planning for this patient?

5) What are two nursing diagnosis for this patient and provide a rationale for each?

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