A 45-year-old male patient presents to the emergency department with complaints of fatigue, muscle weakness, and weight loss. Upon examination, he is noted to have hyperpigmentation of the skin and hypotension. Laboratory tests reveal hyponatremia and hyperkalemia. Based on these findings, the patient is diagnosed with Addison’s disease. Which interventions should the nurse anticipate for the management of this patient? (Select All that Apply.)

Encouraging a high-sodium diet

Administering potassium supplements

Administering intravenous corticosteroids

Monitoring blood glucose levels regularly

Administering diuretics

Answer and Explanation

Correct Answer : A,C,D

Choice A Reason:

Encouraging a high-sodium diet is essential for patients with Addison’s disease because they often suffer from hyponatremia (low sodium levels) due to the lack of aldosterone, a hormone that helps regulate sodium and potassium balance. Increasing sodium intake helps to counteract this deficiency and maintain proper electrolyte balance.

Choice B Reason:

Administering potassium supplements is not recommended for patients with Addison’s disease because they already have hyperkalemia (high potassium levels) due to the lack of aldosterone. Adding more potassium could exacerbate this condition and lead to serious complications such as cardiac arrhythmias.

Choice C Reason:

Administering intravenous corticosteroids is a critical intervention for managing Addison’s disease, especially during an adrenal crisis. Corticosteroids like hydrocortisone help replace the deficient hormones and stabilize the patient’s condition by reducing inflammation and supporting metabolic functions.

Choice D Reason:

Monitoring blood glucose levels regularly is important because patients with Addison’s disease can experience hypoglycemia (low blood sugar levels) due to cortisol deficiency. Regular monitoring helps in timely detection and management of hypoglycemia, preventing potential complications.

Choice E Reason:

Administering diuretics is not appropriate for patients with Addison’s disease as it can lead to further electrolyte imbalances, particularly worsening hyponatremia and hyperkalemia. Diuretics increase the excretion of sodium and potassium, which is counterproductive in managing Addison’s disease.

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Correct Answer is D

Explanation

Choice A Reason:

Primary hyperparathyroidism is characterized by elevated PTH levels, which lead to increased serum calcium levels and decreased serum phosphate levels. The patient’s lab results show low PTH and low serum calcium, which are not consistent with primary hyperparathyroidism.

Choice B Reason:

Chronic kidney disease (CKD) can cause disturbances in calcium and phosphate metabolism, but it typically presents with elevated PTH levels due to secondary hyperparathyroidism. The patient’s low PTH levels make CKD an unlikely diagnosis in this context.

Choice C Reason:

Vitamin D deficiency can lead to low serum calcium levels, but it usually results in elevated PTH levels as the body attempts to compensate for the low calcium. The patient’s low PTH levels do not align with a diagnosis of vitamin D deficiency.

Choice D Reason:

Hypoparathyroidism is characterized by low serum calcium, low PTH levels, and elevated serum phosphate levels. This condition occurs when the parathyroid glands do not produce enough PTH, leading to the observed lab results and symptoms such as tingling, muscle cramps, and fatigue. The patient’s lab results are consistent with hypoparathyroidism.

A. Implementing strict hand hygiene protocols. B. Administering prophylactic antibiotics regularly. C. Encouraging the patient to eat a high-protein diet. D. Limiting the patient’s fluid intake.

Correct Answer is A

Explanation

Choice A Reason:

Implementing strict hand hygiene protocols is the most critical intervention to prevent infection in patients with acute lymphoblastic leukemia (ALL). Patients with ALL are highly susceptible to infections due to their compromised immune systems, which result from both the disease and the chemotherapy treatment. Hand hygiene is a fundamental practice in infection control, significantly reducing the transmission of pathogens. Ensuring that all healthcare providers, patients, and visitors adhere to strict hand hygiene protocols can greatly minimize the risk of infections.

Choice B Reason:

Administering prophylactic antibiotics regularly can help prevent infections, but it is not the most critical intervention. Overuse of antibiotics can lead to antibiotic resistance and other complications. While antibiotics are important in managing infections, they should be used judiciously and in conjunction with other infection control measures, such as hand hygiene.

Choice C Reason:

Encouraging the patient to eat a high-protein diet is beneficial for overall health and recovery, but it does not directly prevent infections. A high-protein diet can help maintain muscle mass and support the immune system, but it is not a primary infection control measure.

Choice D Reason:

Limiting the patient’s fluid intake is not relevant to preventing infections in patients with ALL. Adequate hydration is important for overall health and helps in the management of side effects from chemotherapy. Fluid restriction is not a standard intervention for infection prevention in this context.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A patient with acute lymphoblastic leukemia (ALL) is admitted for chemotherapy treatment. As part of the nursing management, which of the following interventions is most critical to prevent infection in this patient?

Correct Answer is A

Explanation

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