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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Resuming the use of contact lenses 48 hours after retinal detachment surgery is not recommended. Postoperative care guidelines typically advise against wearing contact lenses until the eye has sufficiently healed to prevent irritation and infection. The exact duration will depend on the surgeon’s assessment and instructions.
Choice B Reason:
Driving 12 to 24 hours after the procedure is not advisable. Patients are usually instructed to avoid driving until their vision has stabilized and they have received clearance from their eye doctor. This period can vary but often extends beyond the first 24 hours post-surgery to ensure safety.
Choice C Reason:
Lying with the face up for 2 weeks following the procedure is incorrect. In many cases, patients are required to maintain a face-down position to help the retina reattach properly, especially if a gas bubble was used during surgery. The specific positioning instructions will depend on the type of surgery performed and the surgeon’s recommendations.
Choice D Reason:
Refraining from lifting objects that weigh over 15 lb is an appropriate instruction. Heavy lifting can increase intraocular pressure and strain the eye, potentially disrupting the healing process. Patients are generally advised to avoid strenuous activities and heavy lifting during the recovery period to ensure optimal healing.
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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