A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?

Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia.

Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention.

You will need to increase your dose of corticosteroids due to the stress of surgery.

Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection.

Answer and Explanation

The Correct Answer is C

A. Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia: This is not typically recommended for clients with Addison's disease. In fact, they often need more sodium.
B. Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention: This is not appropriate for clients with Addison's disease. They generally need to maintain adequate hydration.
C. You will need to increase your dose of corticosteroids due to the stress of surgery: Stress, including surgery, increases the body’s need for corticosteroids in clients with Addison's disease. Therefore, increasing the dose is crucial to prevent adrenal crisis.
D. Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection: Hydrocortisone should not be avoided. It is essential for managing Addison's disease and preventing an adrenal crisis, especially under stress.

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Correct Answer is ["75"]

Explanation

Step 1: Determine the total infusion time in hours
• There are 24 hours in a day.
Step 2: Calculate the infusion rate
• Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hr)
• Infusion rate = 1800 mL / 24 hr = 75 mL/hr
Therefore, the nurse should set the IV pump to deliver 75 mL/hr.

A. Pain 7/10 at the surgical site B. Hyperglycemia C. Blood pressure 92/50 D. Sodium 152 mEq/L

Correct Answer is C

Explanation

A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.

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A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["75"]

Explanation

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

Correct Answer is C

Explanation

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